Motion made,
	That so much of the Lords Message [12 October] as relates to the City of Westminster Bill [ Lords] be now considered.
	That this House concurs with the Lords in their Resolution.— (The Second Deputy Chairman of Ways and Means.)

The Secretary of State was asked—

Jim Murphy: In the world we live in, it is a fact that we need these weapons and that they have to be tested safely. It is in the nature of the modern world that, sadly, we need these sorts of ranges. The fact is that the only real threat to defence jobs in Scotland would be Scotland breaking away from the rest of Britain.  [Interruption.] If Scotland left Britain, thousands of British jobs would leave Scotland, including the Western Isles, and that also means shipbuilding jobs on the Clyde and across the whole of Scotland. That also includes RAF bases— [Interruption.]

Mr. Speaker: Order. The group leader of the Scottish National party must behave with due decorum in the Chamber—certainly if he wishes to be called.

Ben Wallace: Despite the Secretary of State's comments about the ranges, they need modernising if they are to keep pace with the next generation of weapons systems, without which our forces will not get the weapons they need to do the jobs we send them on. Will the Secretary of State give a commitment today that his Department and the Ministry of Defence will continue to invest in those ranges while at the same time doing all they can to protect local jobs in that area? Will he also agree with me that—

Anne Begg: Given all the emphasis on climate change, it is not surprising that renewable energy receives a great deal of publicity, but will my right hon. Friend ensure that we do not forget about the oil and gas industry offshore, which will be needed in the short to medium term—if not, indeed, the long term—to fill the energy gap that would otherwise exist? It is important not just to the economy of north-east Scotland but to that of the whole United Kingdom, because there are jobs in the industry throughout the UK.

Brian H Donohoe: Can my right hon. Friend give any idea of the stage that the new licensing has reached? At one time there was drilling in the Clyde estuary. Is there any update on that? It would bring a number of jobs to the Ayrshire area. Will my right hon. Friend take the opportunity of congratulating all agencies in Ayrshire—

Jimmy Hood: May I draw my right hon. Friend's attention to the  Hansard for 16 July? In answer to a question from my hon. Friend the Member for Thurrock (Andrew Mackinlay) as to when he would be given an opportunity to vote for a Scottish Grand Committee to be held, the Leader of the House answered that
	"there needs to be an opportunity for the Scottish Grand Committee to meet, and I will look for an opportunity."—[ Official Report, 16 July 2009; Vol. 496, c. 457.]
	The best way to have a live debate that includes those who are running away from it is to invite them all to the Scottish Grand Committee to have that debate.

Jim Murphy: The Foreign Secretary made a statement yesterday and I have nothing further to add to it. I was here for his statement—not all hon. Members were.

Jim Murphy: I have nothing further to add to what the Foreign Secretary offered in a very long and detailed statement yesterday. The fact is that this was 100 per cent. the responsibility of the Scottish Government—it was 100 per cent. their decision and their responsibility—and they made their decision on their merits. However, I think that the issue was very badly mishandled and those scenes in Tripoli were a national disgrace. The St. Andrew's flag was trailed out on to the tarmac to celebrate that man's return; that image will haunt Scotland across the world. Some damage was done to Scotland's reputation, although I do not wish to overstate it. It is now the responsibility of all of us to work together to rebuild Scotland's reputation across the world.

Ann McKechin: The regulation and funding of networks in the UK is a matter first and foremost for the Department of Energy and Climate Change and Ofgem. Delivering the necessary reinforcements by 2015 will require up to an estimated £4.7 billion of new investment onshore, in addition to current refurbishment and expansion plans requiring some £4 billion to £5 billion, which have already been approved by Ofgem.

John Robertson: I thank the Minister for her answer. She will be aware that £1.4 billion is required to upgrade the transmission system. In addition, new renewables and technology are coming on line. Is she confident that this target can be reached by 2015, given that the Beauly-Denny transmission link is still outstanding from 2000 and has been held up by the current Scottish Government?

Ann McKechin: I thank my hon. Friend for his question and for his long-standing interest in energy issues for the benefit of Scotland. He is right to say that the decision on the Beauly-Denny line is still to be made. That is a responsibility of the Scottish Government, but I hope and expect that a decision will be made this year. The time for dithering is over; it is time for real decisions. That is why Ofgem has already approved £43 million of pre-construction contracts, as part of the £4.7 billion investment, and is working seriously with the industry to ensure that we have the right environment to encourage that investment.

Willie Rennie: Has the Minister had discussions with the Energy Secretary about the punitive charging regime for the construction—the upgrade—during that period of the Scottish-English interconnector? I ask that because there is great concern that the regime will be punitive for Scottish generators.

Ann McKechin: I can confirm to the hon. Gentleman that I have had discussions with the Energy Minister regarding transmission charging in Scotland. We do not believe that the transmission charging regime in any way discriminates against Scotland. I welcome the fact that Scottish Power has recently announced proposals for up to five new wind farms in Scotland—that is a good indication that a lot of people want to invest in Scotland. We are reviewing transmission access, as the hon. Gentleman is aware, and we want to ensure that renewable energy gets the proper priority that it deserves.

Ann McKechin: The hon. Gentleman has a proud track record in campaigning on this serious issue. I welcome his concern today. Many of these matters are devolved to Scotland, but I can confirm that the UK Government and the Scottish Government are working closely together to tackle the problem. That is one reason why we ratified the Council of Europe convention on action against trafficking in human beings last year and why we have set up a national centre for trafficking in Sheffield, with which the Scottish authorities—including the police—are fully co-operating. They are providing us with important intelligence so that we can track these criminal networks across the whole of the UK.

Jim Murphy: The Barnett formula is simple, efficient and effective. It means that every £1 extra public expenditure per person in England is matched exactly for each man, woman and child elsewhere in the United Kingdom.

Jim Murphy: We have considered this very carefully. Recently, the Calman commission—an independent expert group—considered it and said very clearly that the formula is
	"a pragmatic solution to the funding question and is near costless"
	to operate. We have no plans to change the Barnett formula; I know that many of those who sit on the Conservative Benches do. That is one reason why so many people in Scotland distrust the modern Conservative party.

Jim Murphy: We have put party politics aside, and the SNP Scottish Government will be treated in exactly the same way that their Labour predecessors were treated. The best way to get Scotland's climate change interests represented at Copenhagen is through the attendance of my right hon. Friend the Prime Minister of the United Kingdom. As far as I am concerned—and the same goes for the majority of Members of this House, and of people across Scotland—the UK will, of course and for the foreseeable future, include Scotland as an equal, full and strong part.

The Prime Minister was asked—

Gordon Brown: I thank the hon. Lady for her tribute to those brave men who died in Afghanistan, and I hope that the message will go out today that all political parties—every Member of this House—want to send their sympathy and condolences to every family concerned.
	We joined the European Union in the 1970s, and we hold by our obligations to the European Union, but that does not prevent us from representing the national sovereignty of this country.

Gordon Brown: Again, I am very pleased that the right hon. Gentleman associates himself, as I knew he would, with the commemoration of those people who have died during the course of the summer. It has been a particularly difficult summer for our armed forces, and also for the families of those members of our armed forces, with their worries about their loved ones who are serving in Afghanistan.
	What we have tried to do over the past few months is make sure, first of all, that all military men and women on service in Afghanistan, and in any place around the world, are fully and properly equipped for the tasks that they have got to undertake. I am happy to share with the House, in a statement in a few minutes from now, the extra measures that we are taking to protect our troops in Afghanistan, particularly against electronic devices, which have been the cause of 80 per cent. of the deaths over the past few months.
	I also want to assure the House—again, I am very happy to go into this in more detail in the statement on Afghanistan—that we stand by the military covenant with all military families in this country and all serving members and former members of our armed forces. That is why we published a White Paper only a few months ago looking at the range of services, from education and health to the possibility of jobs after members leave the armed forces and help that is given when people are on location in the different countries in which they serve. I believe that that White Paper is an indication—I think that it had all-party support—of the determination of all of us to stand by our military.
	If there are further suggestions about what we could do, I am very happy to look at them. We have an in-service allowance. We have increased the facilities available to members' families for phone calls. We have done what we can to make sure that the pay of the armed forces rises faster than the pay of the rest of the community. We have done what we can at Selly Oak and Headley Court to make sure that we give the succour that we can to those people who have been injured. I believe that if we build on that record, we will be doing the right thing, but obviously I am happy to listen both to members of the other parties and to the Select Committees on what more we can do.

Gordon Brown: Let me pay tribute to the medical facilities that are available both at Camp Bastion and in Britain. I have visited them myself, as I know other Members have. These are the most advanced medical facilities available to our troops and it is right that they are the best in the world. At Selly Oak, which I also visited recently, I saw the care that goes into helping those who are injured, many with very severe injuries indeed. When I visited Afghanistan a few weeks ago and then went to Selly Oak only a day or two afterwards, I saw how quickly treatment was given, as people had been moved with speed from Afghanistan back to Birmingham. I agree with the right hon. Gentleman about the work at Headley Court. We are anxious to continue to support that and are investing more in it.
	With reference to members of the forces who retire or are not able to serve longer in the armed forces, I am concerned that compensation arrangements are satisfactory. That is why, after the recent court cases, the Secretary of State for Defence has set up a review headed by a former Chief of the Defence Staff to look at those issues of compensation. On future employment and some of the projects that have come forward to help armed forces—men and women—who are looking for alternative opportunities after they recover from their injuries, we are determined to do everything we can. I believe, and it is right to say, that there is all-party support for this extra work.

David Cameron: I hope the Prime Minister will look at that specific proposal as well.
	We will discuss Afghanistan in a moment, but I want to ask the Prime Minister a specific question about the Territorial Army, an organisation that plays a vital role in our armed forces and has lost many people in Iraq and Afghanistan. I have had a specific case of a serving officer who is due to go to Afghanistan in October 2010. He has been told that of the training days that he should have between now and then, he will be paid for only half of them. Let us be clear about what is happening. Volunteers—they are volunteers, being asked possibly to lay down their life in the service of their country—are not getting the basic training that they need. Does the Prime Minister agree that this is totally unacceptable?

Gordon Brown: I am grateful to the right hon. Gentleman for supporting the message of condolence and sympathy that we are sending to all the families of those who have been bereaved as a result of what has happened this summer, and I appreciate his direct comments on that.
	On our presence in Afghanistan, let me say first—I shall talk about this in more detail later—that no one can be satisfied with what happened during the elections in Afghanistan. Every one of us has questions that have to be answered, not so much about the security that was attached to the election, because a huge amount of work by our troops and forces went into that, but about the amount of ballot rigging that appears to have taken place. Everybody knows that 1 million votes are being examined out of the 6 million or 7 million votes that happened, but they are the subject of the international commission's examination of the issues. So I hope that the right hon. Gentleman will wait until we have the final conclusion from the electoral commission and then accept that we will have to follow its verdict. I believe that the commission, which is half Afghan and half international, has looked at the issues in a great deal of detail, and I believe that it will report very soon.
	But I have to say to the right hon. Gentleman that, facing an insurgency, it is remarkable that elections took place at all; and it is remarkable that 6,000 polling stations were open at all. That is a tribute to our forces and other forces making it possible for this infant Afghan democracy to hold an election, organised by itself, in the first place. We are there, and I tell him why we are there: we are there to protect the streets of Britain; we are there because al-Qaeda poses a threat to us as well as to other countries; and we are there because, if al-Qaeda took control again or had an influence in Afghanistan under a Taliban Government, the people of this country would not be safe.

Nicholas Clegg: I am grateful to the Prime Minister for his reply, but we cannot live in denial about the total lack of legitimacy of the present Afghan Government. General McChrystal himself has said that the job of our troops is becoming more difficult because of corruption in Government. Hundreds of thousands of votes were given to President Karzai by block votes from a warlord accused of war crimes. So if President Karzai is declared the winner of this flawed election—can I be precise?—will the Prime Minister urge Karzai immediately to form a Government of national unity bringing in opponents from other political groups and other ethnic groups, because otherwise he will risk losing the support of the international community?

Gordon Brown: Of course I understand my hon. Friend's concerns and those of his constituents, and I will ask the Health Secretary to meet him to talk about these issues—but as he knows, the reconfiguration of national health services is a matter for the NHS locally. I understand that the review concluded in July and that it has been accepted by both primary care trusts and by East Lancashire Hospitals NHS Trust. I understand that a programme implementation board is in place, and that the board is confident that this will not undermine services locally. However, he will want to have that meeting with the Health Secretary and he can come back to me afterwards.

Gordon Brown: First of all, in the light of what we knew was happening to interest rates—I hope that the hon. Gentleman will agree that it is important that interest rates are low, not high, at this stage—the Chancellor made proposals in the Budget to improve the individual savings account, and proposals for people to be able to invest more in that individual savings account tax free. At the same time, the hon. Gentleman knows that we have taken measures to ensure that the pension credit is available to 2 million pensioners and that the winter fuel allowance will be paid to pensioners in the next few weeks, with a higher rate for those who are over 80; and we are determined to do our best to ensure that, even in a low-inflation environment, the pension will rise by at least 2.5 per cent. So we are taking the measures that are necessary to ensure that pensioners are protected against a recession that is hitting every country, but in our country we have taken special measures to help the unemployed, home owners, and pensioners as well.

Gordon Brown: We want a settlement of this dispute, and we want to say that this dispute is not in the interests of anybody. I have to say that if Royal Mail starts to lose major contracts such as those of some of the major firms in this country, it will be difficult for it to regain those contracts over a short period of time. I know that Ministers are working actively to ensure that the parties—the management and the work force—are negotiating. I hope that they will do so, and I hope that this unnecessary strike can be prevented.

Mark Williams: I know that the Prime Minister is aware of the extent of the affordable housing crisis across rural Britain and many of the innovative ways in which local authorities are trying to address the problem through section 106 agreements. Does he share the sense of bewilderment and anger of many of my constituents that despite the bail-out of the banks, many mortgage providers are still operating a very belligerent attitude, not giving sufficient mortgage offers to mortgagees and offering them incredibly high and unaffordable deposits, and would he—

Gordon Brown: I do agree with a lot of what the hon. Gentleman said. Building societies and banks have an obligation under the agreements that they have signed with the Government to make available mortgage finance as well as small business finance, at affordable rates, to members of our community. However, I think he will also agree that we have put aside £1.5 billion to build another 20,000 extra affordable homes over the next period of time, for rent and for low-cost home ownership.
	We are doing what we can as a Government to give local authorities more powers to build and to ensure that the private sector responds with offers such as shared purchases and shared equity, as well as the new public investment that we are making. We are doing what we can and will continue to pursue a policy that we hope over time will give everybody an affordable home in this country.

Alasdair McDonnell: The Prime Minister will recall that some months ago I raised serious concerns with him about banks now fleecing small businesses to recover the monies that they lost through foolish and reckless deals. Is he aware that things are getting worse in many cases? Indeed, the Halifax, which is part of the Lloyds group and was effectively nationalised, is one of the worst offenders. Credit has been withdrawn and refused, but worse still I have a note here that says that currently, small overdraft facilities are costing £13 a month, even for £2,000, and that is going to go up on 6 December—

Alasdair McDonnell: Can the Prime Minister—

Gordon Brown: We have signed agreements about lending with these banks, and we are determined to impose them. Our evidence is that large companies are able to get money at the moment and that medium-sized companies are generally able to get money, but there are specific sectors in which it is very difficult. Small businesses need additional help, and that is what we are trying to make available through the Department of Business, Innovation and Skills.
	I can also say that 200,000 companies have been able to get help with their cash flow through the measures that we introduced to help small businesses, and £4 billion has been deferred by the Treasury. That is a measure that we have taken, as we have helped home owners and the unemployed, but it depends on our being willing to spend money to take us out of recession. That is our decision, and that is our choice. It is unfortunate that it does not have all-party support in this House.

Mark Hunter: The RAF has identified the need for three further aircraft to replace Nimrod R1 spy planes. New Nimrods, built in my constituency in Woodford, in which the Government have already invested £3.6 billion, are ideal for the task. Will the Prime Minister therefore explain why his Government have chosen instead to buy 40-year-old American aircraft and how that ties in with his commitment to British jobs for British workers?

Gordon Brown: I know that the hon. Gentleman is interested in future work for his constituents—that is why he is raising this question. I can tell him that we have not made a final decision on the next stage of orders and I will write to him when we do so.

Mr. Speaker: May I ask Members who are leaving the Chamber please to do so quickly and quietly so that we can hear the Prime Minister's statement and Members may have the chance to question him on it.

Gordon Brown: With permission, Mr. Speaker, I should like to make a statement on Afghanistan and Pakistan: first, on our work with the Government of Pakistan to counter the terrorist threat from al-Qaeda and the Taliban; secondly, on our priorities for Afghanistan in the next stage of the work our armed forces and civilians are undertaking there; and thirdly, on the conditions we are setting down for the next stage, including for the best possible protection of our troops, especially against—as I mentioned earlier—the growing threat of improvised explosive devices.
	Earlier this afternoon we honoured those who have died serving our country in Afghanistan. Today, I also want to honour and thank all those who serve and have served there. Each time I visit them, as I did a few weeks ago, I find myself in awe of the immense skill, courage and sacrifice of our forces. It is right that we put on record in this House, and for times to come, our gratitude for the immeasurable contribution by all our armed forces to our security.
	We should also pay tribute to the service and sacrifice of our allies in the 42-country coalition, including that of the 873 American soldiers who have been killed in the last few months, and of two of our closest partners in central Helmand—the Danes and Estonians—who have disproportionately suffered among the largest losses of all.
	Every time I read to this House the names of those who have lost their lives in Afghanistan, every time I write a letter of condolence to their families and every time I meet the wounded at Selly Oak, I ask myself the question that has been asked already today—whether we can justify sending our young men and women to join our allies to fight on the other side of the world. I have to conclude that, when the safety of our country is at stake, we cannot and will not walk away; that three-quarters of the most serious terror plots against the UK have roots in the border and mountain areas of Afghanistan and Pakistan; that, as our security services report directly to me, while the sustained pressure on al-Qaeda in Pakistan combined with military action in Afghanistan is having a suppressive effect on al-Qaeda, the main element of the threat to Britain still emanates from al-Qaeda and Pakistan; and that a peaceful and stable Afghanistan would be a strategic failure for al-Qaeda.
	Our objective is clear and focused—to prevent al-Qaeda launching attacks on our streets and threatening legitimate government in Afghanistan and Pakistan. But if we limit ourselves simply to targeting al-Qaeda, without building the capacity of Afghanistan and Pakistan to deal with terrorism and violent extremism, the security gains will not endure. So over the last two years we have sought to build and support the Afghan army and police and to work with the Pakistan security forces. Our strategy is dedicated to counter-insurgency and what we have called "Afghanisation". This guiding purpose, reinforced in our strategy and in the NATO strategy in April, is at the heart of the announcements I am making today.
	First, there is our work with Pakistan against terrorism and extremism. As a result of the meeting of the Friends of Democratic Pakistan, which I chaired in New York on 24 September together with President Obama and President Zardari, there is now a clear plan for stabilisation and a policy that will assist the reconstruction of those areas of Pakistan where there has been military action recently. We welcomed the recent success of the Pakistan Government who decided to take action against the Pakistan Taliban in Swat, Dir and Buner. The support of the opposition demonstrates that a wide cross- section of Pakistan society now accepts that terrorism poses a threat as serious to Pakistan as to the rest of the world. It is vital that basic services and economic assistance be provided in the liberated areas of Pakistan as soon as security conditions allow. The Secretary of State for International Development is therefore today announcing a further British contribution of £10 million, in addition to the £22 million that we have already provided for humanitarian assistance in those areas.
	Secondly, in Afghanistan we will now move further and faster to implement our strategy, which starts with training, mentoring and partnering the Afghan army and police. The more that the Afghans can take responsibility for security, the less our coalition forces will be needed in the long term—and the sooner our troops will come home.
	In recent weeks, I have discussed this approach with President Obama, Secretary of State Clinton, NATO Secretary-General Rasmussen, and I have met Admiral Mullen, the US chairman of the joint chiefs of staff, and Generals Petraeus and McChrystal, as well as our own military commanders here and on the ground. Britain supports General McChrystal's ambition to accelerate the growth of the Afghan security forces—an ambition that lies at the heart of his report—with the Afghan army building to 134,000 within a year; that is, by next October.
	The Afghans are committed to the recruitment of 5,000 soldiers a month from next spring; the new NATO training mission, established at Strasbourg, expects to help train 40,000 Afghan soldiers in 2010. Britain is setting up a new training centre that will train about 900 junior officers and non-commissioned officers each month. In Helmand, last year there were only 4,200 Afghan soldiers; this year there are an extra 50 per cent.—more than 6,000—and at our request the Afghan Government undertook to send more units to support Operation Panther's Claw. Although those units arrived, they were below strength and not yet fully ready for the task. In a province that faces 30 per cent. of the violence in the country, we need more and better Afghan participation—and we need it from now.
	That is why I can announce that the Afghans will set up a corps headquarters in Helmand and that British forces will be ready to partner 5,000 of the 10,000 Afghan troops whom the coalition will be training in Helmand over the next few months, not just embedding mentors with Afghan units, as we have done in the past, but working integrally right up to the top of the command chain. In future operations, the protection of populated areas must be the shared responsibility of Afghan and coalition forces. This will be central to the new benchmarks and timelines that we, and General McChrystal, will set out as part of a new framework for the transition to Afghan authority. That will involve Afghan forces taking responsibility for the security of the Afghan people, and doing so area by area.
	As 19 Light Brigade completes its tour of duty, I know that the whole House will join me in thanking Brigadier Tim Radford, and the men and women whom he leads, for their service throughout this hard-fought summer, and in sending our best wishes to 11 Light Brigade, which is replacing them. That brigade will deploy with further enhancements to deal with the deadly threat from explosive devices—including more specialist troops and more equipment—to protect our forces, to find and defuse the improvised explosive devices and to identify and target the networks that build and set them.
	It should be noted that 19 Light Brigade was able to prevent 1,200 explosive devices from being detonated. It will pass on that experience of success to its successors, together with the equipment enhancements that I announced on my recent visit, and which will come on stream later this month and next to help them. That includes increased flying hours for unmanned aerial vehicles for surveillance—a 33 per cent. increase for Hermes, 50 per cent. for Desert Hawk and next year 80 per cent. for Reaper. It also includes an extra £20 million committed to a fourfold increase in the total number of Mastiff and Ridgback mine-protected vehicles since April, and the first Merlin helicopters to be deployed in Helmand in two weeks.
	That is highly specialised equipment that must be manufactured, delivered and adapted, and personnel must be trained to operate it before it can be put into action. However, no one should doubt our commitment to responding as fast as we possibly can to this new and deadly threat from the Taliban, and nor should they doubt the scale of our financial commitment to our soldiers and to this campaign. Since 2006-07, we have increased annual military spending on the Afghan operation—spending from the Treasury reserve, in addition to the defence budget—from £700 million to £1.5 billion to £2.6 billion, and now to more than £3.5 billion this year. We are determined to provide our forces with the resources that they need to keep them safe, and to make the right decisions about equipment and troop deployments as part of our wider strategy.
	To meet the changing demands of the campaign, which require greater concentration of our forces in central Helmand, we have confirmed the decision that we made in the National Security Committee in the summer: that one of the British units—the regional battle group for southern Afghanistan—will be redeployed to Helmand with immediate effect. To support our plan and to train more Afghan soldiers and police, while maintaining the security of our forces, I have agreed in principle a new force level subject to the following conditions.
	The first is that a new Afghan Government demonstrate their commitment to bring forward the Afghan troops to be trained and to fight alongside our forces. I talked yesterday to President Karzai and Dr. Abdullah and received assurances that it is their determination that this will happen. The second condition is that, as before, every soldier and unit deployed to Afghanistan is and must be fully equipped for the operations that they are asked to undertake. The third condition is that our commitment be part of an agreed approach across the international coalition, with all countries bearing their fair share.
	The combination of force levels, equipment levels and tasks that I am setting out today follows the clear military advice from our chiefs of staff and our commanders on the ground on implementing our strategy and reducing the risk to our forces. It is on that basis that I have agreed in principle to a new British force level of 9,500, which will be put into effect once those conditions are met.
	As I have said, we do not yet know the results of the first round of the Afghan elections. But although they were the first ever elections run by the Afghans themselves and took place against the backdrop of a serious insurgency, we cannot be anything other than dissatisfied with the intimidation and corruption that has been exposed by Afghan and international observers. The Electoral Complaints Commission has set out a process of investigation, including the disqualification of fraudulent votes, and this process must be allowed to run its course.
	When I spoke to President Obama last week, we agreed that when a new Government are formed, the international community, including Afghanistan's neighbours, must develop a contract with the new Government that includes the commitment to growing the Afghan army; tough action on corruption; a more inclusive political process, including reaching out to the reconcilable elements of the insurgency; and stronger Afghan control of local affairs. Those are the necessary changes that I discussed with President Karzai and Dr. Abdullah yesterday, for without those changes the efforts of our military will be hampered and the new Afghan Government will not gain the trust of the Afghan people.
	A better future for Afghanistan, with its village and rural population, can only be forged if there is stronger governance right down to district level. Last year we doubled the number of advisers we put in for civilian help, and now our joint civilian-military teams—the first in Afghanistan—are supporting not just Governor Mangal, but district governors and village shuras. During the past year, four new district governors have been appointed in Helmand. The Afghan Government are now functioning in nine out of their 13 districts, compared with five last year, and we are supporting community councils to consult with thousands of local people.
	To ensure that this work has immediate backing, we have announced an extra £20 million for the stabilisation work in Helmand—money that is already being disbursed—to increase the number of Afghan national police in Helmand by 1,000 a year for each of the next three years and to build a new police training academy and new facilities for district governors. We are also working with coalition partners to extend such support to the 34 provincial governors and 400 district governors right across Afghanistan.
	British aid will therefore continue to help to pay the salaries of teachers and doctors, but we are also ready to fund and partner the first Afghan teams sent for stability purposes from Kabul to work alongside us in Helmand. We want to reinforce the hard-won gains of our forces in this hardest of summers while fostering greater Afghan responsibility for their own affairs.
	We will have prevailed in Afghanistan when our troops come home because the Afghans have not only the will to fight, but the ability to take control of their own affairs. The right strategy is one that finishes the job, giving Afghans the tools to take over themselves. A safer Afghanistan is a safer Britain. A stronger Pakistan is also a safer Britain. We must never again let the territory of this region or any region become a base for terror on the underground or in the streets, cities and airports of Britain. We must not permit it and we will not permit it. We have the right strategy and we will see it through. I commend this strategy to the House.

David Cameron: We have long called for regular reports to Parliament on Afghanistan and Pakistan, so we very much welcome this statement. I would like to ask the Prime Minister about three areas: first, Britain's input into the US strategic review; secondly, the equipment for our troops; and thirdly, the military's request for extra troops.
	On our overall strategy in Afghanistan and Pakistan, and President Obama's review, the Prime Minister said that he supports General McChrystal's ambition, but can he tell us whether he basically agrees with General McChrystal that we need a proper, fully fledged counter-insurgency strategy in Afghanistan? The Prime Minister rightly says that our military effort should increasingly be geared to training the Afghan national army. We agree with that and support it, and we welcome the extra Afghan troops who will be in Helmand, but does he agree that in order for this to work, the Afghan national army needs to be more representative of the country as a whole? Can he tell us what progress is being made on that vital front?
	As the Prime Minister said, the recent elections were widely seen as flawed and corrupt. If reruns of contests are not possible, does he agree that the clearest possible message should be sent to President Karzai that when British soldiers are fighting and dying for his country, the corruption and ineffectiveness of his Government are completely unacceptable?
	On the Taliban, do we not need to get much smarter at distinguishing between individuals who pose a real long-term threat to the security of the UK and its allies, and those who do not? Does the Prime Minister agree that, while we should not be negotiating with the leadership of the Taliban, we should be breaking up the movement, separating out those who are more motivated by money or other factors rather than by ideological commitment? Can he tell us a bit more about what progress is being made on this front?
	As the Prime Minister has rightly said, security in Pakistan has a direct link to security here in the UK. While the success in the Swat valley of which he spoke is welcome, the recent siege at the army HQ in Rawalpindi—just a few miles from the Pakistan capital—was deeply disturbing. Will he tell us what the British Government are doing to increase the Pakistan Government's ability and capacity to deal with the rise of extremism? Will he address specifically the question of what he thinks is now being done, if anything, to shut down the Quetta shura?
	The Prime Minister has said that the deployment of extra troops is conditional on the military assuring him that they have the necessary equipment and training, but will not people think that it is the Government's responsibility to ensure that they have the necessary equipment? Will people not also ask why, after eight years, we are still playing catch-up on equipment? As we have said repeatedly, helicopters are crucial. Will he tell us what progress has been made on getting more Chinooks to theatre? He said in his statement that the "first Merlin helicopters" will be deployed in the next two weeks. Can he assure the House that all six Merlins from Iraq will be in Afghanistan by the end of the year, as he promised? We welcome the delivery of the new Ridgback and Mastiff armoured vehicles, but, according to yesterday's Public Accounts Committee report, only one in five of the Mastiff fleet were classified as fit in June 2008. Will he tell us whether that completely unacceptable position has now improved?
	The Prime Minister tells us that the troops going to Afghanistan will be properly trained and equipped, yet today we see that training for the Territorial Army, including some who are going to Afghanistan, has been cut. Will people not conclude from that that he is not fully on top of what is happening in his own Government? On the additional 500 troops that he has announced, can he confirm that that is what the military have actually asked for? Vitally, will he also make it clear that the troops announced today are new, additional soldiers, not troops who are already there and who have had their stay extended?
	I want to return, if I may, to what the Prime Minister said to me when I asked about the military's request for extra troops in the summer. On 13 July, in the House, I asked him specifically whether commanders had asked for more troops to do more things and whether he had been asked for 2,000 more troops. He replied:
	"I have been reassured by commanders on the ground and at the top of the armed services that we have the manpower that we need for the current operations."—[ Official Report, 13 July 2009; Vol. 496, c. 26.]
	Yet we now know that the military did ask for 2,000 more troops in March this year. Will he tell us why that option was rejected? Will he also explain why he gave such an evasive answer on such an important issue as troop numbers? Does he not understand that we are only going to carry the public's confidence if we are straight with them about the choices that we face?
	Finally, let me ask about what is being done to put our entire effort in Afghanistan on to a proper war footing in Whitehall. We need a clear sense of direction from Ministers, a clear sense of who is in day-to-day charge, and a Government machine that responds quickly and decisively. Will the Prime Minister tell us today what he is doing to make that happen? Let me be clear: we support the mission in Afghanistan, provided that we are realistic about what we are aiming to achieve. To us, the overriding aim must be to train the Afghan forces so that they can take responsibility for their own security and our soldiers can come back home.

Gordon Brown: I will answer every specific point that the right hon. Gentleman has raised, but I want to stress that the decisions that we are announcing today have been made after the fullest possible consultation with our American allies, with the Secretary-General of NATO, with our own military commanders on the ground and with the Chief of the Defence Staff and the Chief of the General Staff. I have regularly met them over the past few weeks to deal with these issues.
	The right hon. Gentleman should also be aware that the National Security Committee has been meeting every week throughout the summer to review events and dispensations. That committee has the advantage of being a committee not simply of Ministers such as the Foreign Secretary, the International Development Secretary, the Defence Secretary, myself and others; its membership also includes the commanders themselves, our security services and those people who can advise us on the issues on the ground. On some occasions, we have had a regular input from our ambassador in Kabul. It is completely not the case that these matters are not being properly co-ordinated at the centre of Government by a National Security Committee with the advice of our commanders at all times and with regular meetings and discussions with our allies.
	Let me deal first with the right hon. Gentleman's question about Pakistan. He is absolutely right to say that there are risks in Pakistan, as the Pakistan Taliban in particular are engaged in activities against the Pakistan Government. He should also note, however, that in the past few months in Pakistan we have seen the most encouraging coalition of forces: the Opposition parties as well as the Government, and the security services as well as the army, are determined to take on the Pakistan Taliban in those areas where they have a foothold. They are taking the fight to them, removing them from the territory and doing an incredible amount of work to ensure that displaced people can get back into their own areas.
	This was reflected in the Friends of Democratic Pakistan meeting that we held at the United Nations. That meeting involved not just ourselves and America; there was representation from all the major countries in Europe and elsewhere wanting to support the efforts of the Pakistan Government to deal with the problem that they face. I have had assurance from President Zardari—we know that there have been discussions because the Defence Secretary and the Home Secretary were in Pakistan very recently; the Foreign Secretary is also in direct touch—that the Pakistan Government plan to take their campaign from the Swat valley into Waziristan at some point. They are planning how to deal with not only the Pakistan Taliban but the Afghan Taliban and al-Qaeda itself. It was encouraging, having defined the problem as one that covers the border areas of Afghanistan and Pakistan, that while we had hoped for years that the Pakistan authorities would take action, they are now doing so. As the Leader of the Opposition said, they recognise that the terror threat is very close to home for them.
	On Afghanistan, I was asked about General McChrystal's report and about a number of issues relating to equipment. I want to ensure that people understand the process of consultation that we have gone through, and the logic of the decisions that we have made. The basic elements of General McChrystal's report relating to the principles of future operations involve a move from counter-terrorism to counter-insurgency, and a move from an emphasis on holding areas to being with the largest areas of population and winning hearts and minds. The aim is therefore not simply to eliminate the Taliban but to win the support of the Afghan people. It is for that reason that the general is proposing—rightly so; we ourselves proposed this some months ago—that the partnering and mentoring of the Afghan forces to build up the Afghan army and security forces are absolutely central to everything we do.
	When we went in on Operation Panther's Claw, we wanted the Afghan forces to hold the ground. They came, but they were not strong enough or well equipped enough to do so. We need an Afghan army that is properly strengthened and properly equipped. As the right hon. Gentleman rightly says, that means getting a balanced army across the country as well as getting troops to come from other parts of the country to Helmand, where 30 per cent. of the violence takes place. Our aim is to move from an Afghan army of 90,000 to one of 134,000, and to train the troops but also to have them in action with our own troops right up to headquarters level. We believe that, in the next year, that extra 50,000 or so troops can be achieved through a recruitment rate of 5,000 a month and through those troops being sent into Helmand.
	The integration of people who are part of the Taliban or the insurgency and who could be persuaded to come over is a central element of the work that we are doing. The Foreign Secretary emphasised that in a speech only a few weeks ago. The importance of it has led General Lamb, who acted with great distinction in Iraq, to go to work with General McChrystal on the very process of reintegration and splitting the Taliban.
	There are Pashtun nationalists, people hired for a dollar or two a day, young people who want to assert their independence, and Taliban and al-Qaeda ideologues. We have got to separate the people who worry that they are hit with an occupying army from those who simply want al-Qaeda or the Taliban to regain control of Afghanistan and practise terrorism from that country. I believe that all parties share our determination on political reconciliation, but it is important to note it.
	Let me answer the questions on equipment. There will be two Merlin helicopters there very soon and our plan is get six there as soon as possible. The problem has been that we have to re-blade the helicopters from their work in Iraq; then the pilots have to be trained for the difficult and different terrain of Afghanistan. That work is going on; I have seen it at first hand when I have visited the RAF base in which it is being done. I was also asked whether we would have other helicopters. Chinooks will be going there next year; Lynx has been remodelled for high intensity and very hot atmospheres, and they are going there from next summer. With Mastiff and Ridgback, I think I am right in saying that 500 vehicles have been sent to Afghanistan in the last period of time. The equipment for Mastiff and Ridgback is now second to none. Of course we want to get more there as soon as possible, and we are making that happen.
	I have already said that I will investigate what the Leader of the Opposition said about the Territorial Army, but I emphasise to him that the Territorial Army is part of our mission in Afghanistan. Anybody who goes to Afghanistan has the assurance that we will do everything in our power to make sure that they are fully equipped for the tasks that they undertake.
	I was asked about the numbers of troops in Afghanistan and the issues that arose. A number of options were before us earlier this year for different kinds of operations that we might mount in Afghanistan. We took the necessary decision to send more engineers to Afghanistan to protect ourselves against the IED threat. A range of options were discussed and we decided to raise the number of troops from 8,100 to 9,000 until we could see what was happening with the American review of strategy and also what happened during the election campaign. We raised the number from 8,100 to 9,000, and we are now making a decision to raise the number again from 9,000 to 9,500. We are redeploying the regional battle group to central Helmand, because that is the best use of it as we try to undertake the task of protecting our forces while at the same time conducting our Afghan support exercise for Afghan troops. The decisions taken have been agreed by all our military advisers as the right decisions to take for the future.
	The reason for imposing conditions is obvious. We cannot train the Afghan forces without the Afghan Government making those forces available to be trained. We want to go in harmony with the American decisions that General McChrystal and the President are discussing. I believe that what we are saying today is consistent with what the Americans will decide.
	Of course, we want to be absolutely sure that the troops we send are properly and fully equipped for the future. In other words, whenever there has been a need for us to protect our troops and to move forward the campaign, which is now about Afghans taking more responsibility, we have been prepared to send the troops, to make the investment, to provide the finance and to support the troops on the ground. I hope that the Conservative party will be able to maintain what has been a consistent bipartisan approach to a necessary exercise in Afghanistan, and that we can proceed on the basis that there is support in all quarters of the House for the activities that we are undertaking.

Several hon. Members: rose —

Gordon Brown: That is one of the approaches that we are considering. The European Union responsibility for the training of police forces has been with Germany, and it has done a great deal, but more must be done. It is possible to envisage circumstances in which the army will help with the training of police forces, and it is possible that there will be more civilians training them as well. I agree with the right hon. Gentleman that we cannot just talk about training the army. As I said, General McChrystal recommended a build-up of the police forces from 98,000 to 150,000. That is a big increase, but those forces must be in the right places, they must of course be paid—that is one of the problems that we have experienced before—and they must be free of corruption. That is an order that the Afghan Government must accept.

Gordon Brown: The right hon. and learned Gentleman has made an important point. In hand-to-hand, one-to-one fighting, the Taliban have lost. That is why they have changed their tactics, and why their tactics are now essentially those of guerrilla warfare. That is why they are laying devices to kill or maim our soldiers, and why 80 per cent. of deaths—not just British fatalities, but fatalities across Afghanistan—arise from the use of IEDs.
	The right hon. and learned Gentleman is absolutely right to suggest that the Taliban cannot win a conventional war, but can only disrupt our attempt to bring peace and stability to Afghanistan. He is also absolutely right to say that we must think ahead. We must send a message to the Taliban that we are not going to walk away, and that—as he rightly suggests—NATO will stay the course. At the same time, however, we must be prepared to integrate those elements of the insurgency who are not among the Taliban ideologues into the framework of a civilian society that can develop in the future.

Gordon Brown: My hon. Friend is absolutely right that there must be burden-sharing. Before the elections, I and others persuaded some other European countries to contribute more, and there was a greater contribution from other countries in the run-up to the elections. It is now for all of us—once the strategy is set out by President Obama and then by NATO itself; and there is a meeting taking place in the next few days to do that—to persuade other countries that this is the right way forward for them. Some countries will find it better that they are training Afghan forces and not engaged in military action on the ground; some will be prepared to contribute more money rather than more helicopters; some may be prepared to contribute equipment rather than staff on the ground—but everyone must accept that if they are part of the coalition they have got to share the burden.

Mark Lancaster: As I am a member of the Territorial Army who has served in Afghanistan, the Prime Minister will understand my particular interest, and it is worth remembering that a large percentage of our forces in Afghanistan are members of the reserve. Indeed, as one of the EOD—explosive ordnance disposal—trained engineers to which the Prime Minister referred, it is likely that I may have to go there again, perhaps even sooner than I think after this question. This week, however, I was told that I may not be able to train again until next April. How can that be right and, more importantly, what sort of message does that send to the members of the reserve forces whom the Prime Minister claims to value so much?

Gordon Brown: First, Afghanistan is very different from Iraq. Secondly, the right hon. Gentleman should accept that the figures I have given for the army are the increase in numbers over the next year—from 90,000 to 134,000. That is not necessarily the limit on the numbers that will be placed in the Afghan army or the limit of our ability to train members of the Afghan army. I have already given a figure on the rising numbers of police who will be trained for the future. As we know, in the end, Afghan civil society at the local level must operate as well, and where it does operate successfully—perhaps through tribal chiefs, the shuras that have been developed, or the community councils that have been created—that can make a huge difference. We are dealing with a different country and different conditions, but the limits I have referred to on the training of the army for the next year are not the limits on the army for the future.

Gordon Brown: I agree that one of the big questions is how we can train Afghan forces at a far more rapid rate than before. At present, we are seeing recruitment of Afghan forces at a rate of 2,000 a month. That will rise to about 5,000 a month. Of course, not every one of them will go on to get full training or even turn up, so we are talking about an estimated increase of 4,000 a month over the next year. I have talked to General McChrystal about this, and we have talked to the American authorities as well as to NATO, and it seems to be a practical proposition. Steps are being put in place for it to happen. Karzai is sure that he can provide the numbers of those who will be prepared to be recruited to the armed forces. That is the first stage; if we are to go in to train, we must have the Afghan forces with whom to do so.
	On numbers, I want to make sure that the House understands what I said earlier. I said that we discussed a number of options earlier this year. None of them included raising the number of forces by 2,000. We discussed several options. We decided to raise the numbers to 9,000. We decided we would review that after the elections had taken place because a lot rested on security related to the conduct of the elections. We have now conducted that review, and we have been in touch with the Americans, and by agreement with our commanders on the ground and the Chief of the Defence Staff, the Chief of the General Staff and others who have been involved—I met all the chiefs yesterday for breakfast—we have decided on the increase to 9,500 subject to the conditions I set out. I hope people will understand that at all times we have acted in good faith.

Mark Durkan: First, may I associate myself with the respect paid by the Prime Minister to all those who have lost their lives in Afghanistan and all who have loved them.
	The Prime Minister's statement puts considerable emphasis on growing the capacity of the Afghan army. Does he recognise some future danger in building an ever stronger army if at the same time we indulge a systemically weak and corrupt Government? Does the history of Pakistan not point out the danger of such an equation, and what is being done to mitigate these risks?

Gordon Brown: The hon. Gentleman makes the very important point that if we are to have Afghan responsibility for Afghan affairs, we need both local and national Government who work effectively. I would perhaps put more emphasis than the hon. Gentleman on local government being effective. For most people in Afghanistan the hold of central Government is very weak indeed. However, I agree that President Karzai and those who will hold authority in Afghanistan after the elections—whoever they are—must take responsibility for making sure that we have corrupt-free government across the country. A lot is related to the heroin trade, as has been said, but there is a responsibility on those who rule Afghanistan to make sure that the confidence we have placed in them by sending troops to deal with the problems is repaid by their cleansing the Government of corrupt activities. That will be part of the contract with any future Government in Afghanistan.

Bob Russell: The Prime Minister's statement was silent on the continued abject failure of the major European NATO countries to provide troops on the ground in Helmand province. In respect of his comments on hearts and minds, may I suggest that his Government take some leadership? Over the summer his Ministers have told me:
	"No steps have...been taken by UK Trade and Investment to encourage the export of goods from Afghanistan"
	and
	"No locally produced food has been procured for British troops in Helmand Province by the MOD Food Supply Contractor."—[ Official Report, 14 September 2009; Vol. 496, c. 2188W and 2122W.]
	Is there not a case for the British Government to boost the economy of Afghanistan, and in that connection may I urge his Ministers to discuss matters with UK-based charity POM354, which is doing that on the ground in Afghanistan as we speak?

Linda Gilroy: The Prime Minister mentioned in his statement welcome investment to ensure that the kit and the equipment to back up our brave armed forces in theatre is available. On the question of Army vehicles, he mentioned the Ridgback and the Mastiff—of course, the very successful Jackal vehicle has also been used. Can he assure me that the MOD is looking at a replacement for the Snatch vehicle that combines protection and a lower profile, so that as we move into stabilisation that kind of vehicle is available for our armed forces?

Gordon Brown: There is a 41-nation coalition that sees its responsibility as making sure that we can deal with the terror threat of al-Qaeda and that the Afghan Taliban do not return to power in the way that they did before. I must say to the hon. Gentleman that 6 million children are at school in Afghanistan—1 million girls, who would never be at school if we left Afghanistan to the Taliban, are at school. More importantly, people in Britain are safer. Three quarters of the plots that we have discovered in Britain come from the Pakistan border area. If the Taliban and al-Qaeda are allowed to roam free there, we are at risk. Whatever difficulties he diagnoses from the history of Afghanistan—many conclusions can be drawn from its vexed history—we have a duty to protect our citizens and to ensure that we do everything in our power to build the capacity of the Afghan people to run their own affairs.

Gordon Brown: I have to say to my hon. Friend that we have laid out a strategy that does not leave things as they are. It is strategy that says that we have to train Afghan forces and that they must be in a position to take responsibility where British troops, and American and other troops, are taking responsibility now. That seems to me to be the best way forward. That training function will require us to make a contribution to it. We are prepared to make our contribution, and I believe that there will be wider support, both in this House and among the general public, than he suggests.

Gordon Brown: I have just said—I hope that I am able to emphasise this—that the reason why those troops are being put into Afghanistan, which is being done on the conditions that I have set out, is to achieve not only security for our existing forces, but the training of Afghan forces. That is why we are doing this, and that is why the policy has moved from where it was a year or two ago to emphasising the build-up of Afghan forces and of Afghan police, so that Afghans themselves are able to take responsibility for their own affairs. If we do not build up the capacity of Afghanistan to deal with its own problems, at some point either the Taliban or al-Qaeda, influencing the Taliban, will have a bigger say in the running of that country. That is something that we need to avoid.

Gordon Brown: I have just said that there is going to be a new training academy for police. That is one of the ways in which we can improve the quality of the police. I have also been in Helmand and watched how the Afghan police have worked side by side with the Afghan army and with the British civilian and military efforts. That has been a successful operation, and by building out of these successful operations, we will get the progress that we need for the future. Yes, national police training is essential. Quality is necessary, as is a corruption-free police force, and people will have to move around the country, because the recruits come from areas that are not necessarily the areas where we need people to be placed. However, the measures that we are putting in place—including the national police training academy—are designed to achieve that.

Madeleine Moon: The role of NGOs and skilled civilians from across Government Departments, working alongside the Army, is critical to a comprehensive approach to supporting and building civilian capacity. Will the Prime Minister tell the House whether UN resolution 1325, which builds on the important role of women in working to build civil capacity and towards peace, is part of our overall approach in Afghanistan?

Douglas Hogg: The right hon. Gentleman has said that the additional deployment is dependent on coalition countries taking a fair share. Will he tell us what he means by that? What assurances has he received and will he give an undertaking that we will not see an additional deployment of British troops until other coalition partners have made their intentions wholly plain?

Adam Holloway: Frankly, I am staggered at the Prime Minister's characterisation of the deaths from IEDs as being caused by foot patrols and not by the lack of helicopters. Commanders regularly complain of unnecessary logistical road moves. Will he not admit that many of these people are dying for lack of helicopters—yes or no?

Gordon Brown: The hon. Gentleman will have seen that Tim Radford, who commanded Operation Panther's Claw, said that the operation was not hampered by the absence of helicopters. The hon. Gentleman must recognise that the deaths that have occurred from IEDs have occurred in different ways—some have been from vehicles that have been blown up and some from foot patrols—and he must look at the evidence.

Sammy Wilson: From the long IRA campaign in Northern Ireland, we recognise the value to terrorists of being able to set up training bases in the haven of a safe foreign country. For that reason, we believe that the troops in Afghanistan are doing a sterling service for all people in the UK. I also welcome the Prime Minister's announcement that we are now spending £3.5 billion on supplying troops, but given the reports about the unreliable equipment, the underestimation of the reserves that are required and creaky procurement in the MOD, what efforts are being made to ensure that the money is being spent on the right equipment and on an effective supply chain?

Gordon Brown: We are giving more money to the Afghan effort, not less. The money has gone up substantially over the past few years and for one reason—we want our troops to be properly equipped. Let me make it absolutely clear that the people who are in Afghanistan are in the numbers required for and are equipped for the operations that we agreed. If different operations were agreed, there would have been different numbers, but the numbers were there for the operations that were agreed and to meet the requirements of those operations. There should be at least some understanding of that. Of course, there could have been different operations and different numbers, but for the operations that were carried out, the forces that were required were there.

Gordon Brown: I think that I should tell the right hon. Gentleman—although he might not accept it—that over the past few months, in the run up to the election, additional troops were put in by some countries. That was a result of the meeting of NATO that took place on the borders of Germany and France earlier this year, where a number of countries committed to extra troops. We said—this was controversial, because some Members of the House did not agree with it—that we would review the position after the Afghan elections and in the light of General McChrystal's review. That is what we have done, and it is what we will ask other countries to do, too.

Brooks Newmark: I beg to move,
	That leave be given to bring in a Bill to require NHS bodies in England to provide cervical screening for women aged 20 and over.
	The Bill would bring England in line with Wales, Scotland and Northern Ireland, which all begin screening at the age of 20. Cervical cancer is the second most common cancer in women under 35 in the UK. Every year, more than 2,800 women in Britain are diagnosed with cervical cancer, and every year 1,000 women die from the disease. Thankfully, regular cervical screening can detect and treat early the abnormalities that, if left untreated, could lead to cervical cancer. Since the launch of the NHS cervical screening programme in 1988, early detection and treatment has had an excellent success rate. More than 90 per cent. of screening results come back normal, but for the few whose results do not, the test can, quite simply, make the difference between life and death.
	The new human papillomavirus vaccination programme—HPV—was also introduced last year for girls aged between 12 and 15, and this autumn it will be extended up to the age of 18. So, we have a vaccination programme that ends at the age of 18 and a screening programme that begins at the age of 25. That leaves young women between the ages of 18 and 25 caught in a medical limbo, eligible for neither vaccination nor screening.
	My Bill seeks to narrow that gap. By making cervical screening available to any woman aged 20 and above, an extra 1.3 million women would have the choice of cervical screening. The support for lowering the screening age to 20 comes from organisations that range from Marie Stopes International and Jo's Trust to  The Sun newspaper, which ran a petition with over 108,000 signatures. In addition, recent polling by Harris for the  Metro newspaper showed that 82 per cent. of 16 to 24-year olds in England agree with lowering the screening age.
	In 2004, the Government raised the age from which cervical screening can begin from 20 to 25. Their justifications were that cervical cancer is rare in women under 25, that the anxiety and stress of unnecessary investigation and the treatment for abnormal cells is proportionally excessive, and that the age limit is now in line with World Health Organisation recommendations.
	Cervical cancer may be rare in women under 25, but it is inexcusable to dismiss the cases that occur as negligible statistics. Unnecessary investigation and treatment when an abnormal test is proved wrong may be stressful, but it is not for the Government to presume to know best what young women want. If a young woman knows the risks associated with treatment, the decision about whether to proceed with screening and any further treatment should, by rights, be hers alone.
	Although the Government claim that raising the screening age to 25 brings it into line with World Health Organisation recommendations, the age at which screening can begin varies across the world. Oddly, England has chosen to raise its screening age and be out of step with even its closest neighbours. When England raised its screening age in 2004, Scotland, Northern Ireland and Wales all kept screening from the age of 20. In America, screening also begins at 20, or within three years of first sexual contact, whichever is earlier. In Australia, screening begins even earlier, at the age of 18. England's screening age of 25 looks out of step by comparison.
	So why do our Government have a blind spot when it comes to this critical health issue? I fear that it may be down to Budget restrictions: this Government's mismanagement of the country's finances over the past 12 years has forced them to cut critical health care services—an observation clearly supported by many 16 to 24-year olds in England, according to a recent poll by Harris.
	The Government are concerned about funding, yet the numbers attending for cervical screening are actually falling. In 2007-08, a quarter of those invited did not attend. Alarmingly, the biggest drop was in the 25 to 29 age bracket, with attendance numbers falling from 79 per cent. in 1998 to 66 per cent. in 2008. Although I understand that demand for screening may have increased in 2009 due to the Jade Goody effect, we cannot rely on those numbers being sustained.
	The Government's health policy needs to move with the times and be realistic about changing lifestyles. Young women are now more at risk from cervical cancer than ever before, as the contributory causes of unprotected sex and smoking are on the rise. At some point in their lifetimes, 75 per cent. of sexually active men and women come into contact with the HPV virus that causes cervical cancer. With British teenagers now becoming sexually active earlier, the chance of a young woman developing serious cell changes and early-stage cancer before the age of 25 is increasing.
	As I mentioned earlier, there is another weapon in the fight against cervical cancer—vaccination. It is not my intention in this speech to examine the rights or wrongs of that vaccination, as my hon. Friend the Member for Reigate (Mr. Blunt) has already highlighted that in a previous Adjournment debate. However, the vaccination programme has implications for the Bill that I am proposing today.
	I am concerned that some young women could see vaccination as a "silver bullet" solution, leading them to assume that it has protected them from all risk and that there is now no need for them to attend their screening appointment. Screening and vaccination share a common purpose, yet Government policy seems contradictory. Even by their own admission, the Government do not yet know the full risks of the HPV vaccine Cervarix, but nevertheless they are pressing ahead with the programme. Yet the same lack of certainty exists in the risks outlined in the Government's argument against reducing the screening age to 20. That just does not stack up. One cannot use the same rationale in support of one cervical cancer prevention scheme and in denial of another. What is so frustrating is that there was, until 2004, a good, sound policy in place. The Government requested a further review earlier this year but, unfortunately, they have decided to stick with the latest guidelines.
	I hope that the argument that I have presented today will convince the Minister that there is still a strong case to be made for lowering the age of cervical screening back down to 20. With this Bill, we have the opportunity to try and beat one of the deadliest cancers in this country; we must take it. I commend the Bill to the House.

Evan Harris: I rise briefly to oppose this Bill. I do not do so out of any personal animosity towards the hon. Member for Braintree (Mr. Newmark), whom I know well from our work on the Health Committee, but because I think that the premise on which it is based is entirely flawed. I was not sure what the hon. Gentleman was going to say, but what he said made me more convinced of the need to put on record the scientific evidence for the approach taken by the Government.
	I do not lightly defend what the Government are doing, but I think that they have been absolutely right about both the screening programme and the introduction of a vaccination programme. I want the House to consider the nature of a screening programme, and to show hon. Members that the way in which it is being done in England is appropriate. In addition, I want to show that the reference that the hon. Member for Braintree made to the vaccination programme was flawed.
	A good screening test must be both sensitive and specific—"sensitive" in the sense that it must pick up as many as possible of the things that is designed to find, and "specific" in the sense that it should not pick up what it is not supposed to find. The problem of false positives leading to treatment is a real one, and there are two difficulties with screening at a young age. First, the condition being sought is rarer in the young, and there is good evidence that the lesions that are suffered do not progress as quickly as is the case when the person is older. Secondly, early screening can lead to over-treatment, the risks of which—especially given the possible impact on fertility—are greater among younger women.
	When talking about the use of public money, it is not good enough to say that a non-evidence-based screening programme that is neither sensitive enough nor specific enough will be introduced, and then to leave it to people to make the choice. The funding spent on such a programme could be spent on other interventions to treat established disease or to screen in other areas of ill health where the evidence is better. It is not good enough to say that the matter can be left to individuals to make the choice, because the spending decisions involved have to be made responsibly.
	It is certainly not logical—I am afraid that it is totally illogical—to talk about the existence of a gap between the ages of 18 and 25. The hon. Member for Braintree said that the catch-up programme ended at 18 and that the screening programme started at 25, but it is not an either/or matter. People who are vaccinated will go on to get screened. The fact that the catch-up programme ends at 18 makes it an independent variable, and there will be no more catch-up after the programme has taken place. The gap will widen as more people are vaccinated, but the hon. Gentleman's statement was both meaningless and misleading.
	When we look at whom to trust on these matters, it is important not to listen to politicians or even—dare I say it?—to journalists. The hon. Member for Braintree cited evidence from  The Sun, so I want to refer to a recent edition of the  British Medical Journal, which I mentioned to him earlier in the summer.
	In the  BMJ edition of 8 August 2009, a study by Sasieni and colleagues asked:
	"Does the association between cervical screening and a subsequent decrease in the incidence of cervical cancer vary with age?"
	The summary answer was:
	"Cervical screening at ages 35-64 is effective at preventing cervical cancer. It is less effective at ages 25-34 and has no effect at ages 20-24."
	That is a pretty clear judgment, so it is not as if there is a benefit to be set against the risks; on the basis of the study, there does not appear to be a benefit.
	I always caution hon. Members against listening to the results of one study, because one study may not be representative of the field. Usefully for us, the  BMJ commissioned an editorial commenting on that study and a number of others. The editorial, by Guglielmo Ronco of Turin, summarised the study and said that, according to the study, screening is effective only from the age of 35. It said that
	"effectiveness in preventing cancers in the five years after screening is limited below age 25".
	It commented:
	"The large sample size allowed analysis of the cancers by stage",
	and there was no finding, when the cancers were stratified by stage, that undermined the conclusions made. The editorial went on to say:
	"The question is whether to screen younger women, and if so, how? In many developed countries the low incidence of invasive cervical cancer and the lack of effectiveness of screening in young women indicate that screening should not start before the age of 25. For women aged 25-34, screening with HPV testing alone is much more sensitive than screening with cytology, but it is also less specific."
	That is a reference to another technique that could be used for screening, which it would be useful to debate. We might debate whether we should test for the presence of the human papillomavirus, because that test has greater sensitivity. However, one would find people with the virus who did not have any lesions and were therefore clearly not likely to develop cancer at that point. There is an argument that we should look into that, and I hope that the Government will continue to examine that area.
	The hon. Gentleman mentioned the cervical cancer or HPV vaccination programme, and it is important to say a word in defence of it. There is very good evidence that it will save lives, because of the very high effectiveness of the vaccine at preventing infection with HPV, which has been demonstrated to be the cause of many cervical cancers. There is clear evidence of benefit, and I urge parents—as do the Government and, more importantly, medical experts—to ensure that their children are vaccinated.
	Of course, it is impossible to say that any vaccine is entirely safe. That is not something that should be said, or that can be said. However, it is a matter of balancing benefits against risks. There is great known benefit to the programme, and if there is a risk, it is known to be small. I very much regret, as I hope that the hon. Gentleman does, the coverage of the issue in  The Sunday Times two weeks ago. In an article asking, "What has cervical cancer drug done to our girls?" it cited the case of Natalie Mort, who died after having the vaccine, but who, post mortem, was found to have a tumour in her chest. The pathologist said that it was
	"so severe that death could have arisen at any point".
	It is extremely disappointing that the article went on to quote a parent—

David Willetts: I beg to move,
	That this House congratulates those who have secured a higher education place for 2009-10 and wishes them well in their studies; regrets the increase in the number of applicants unable to secure a place this year; further regrets the financial difficulties faced by up to 175,000 students who started term without the loans and grants to which they are entitled; believes it is unacceptable that three-quarters of a million telephone calls to the Student Loans Company went unanswered in three months and that an avoidable contact policy was adopted; notes with regret that warnings about the problems in Student Finance England appear to have been ignored; asks the Government to clarify the treatment of emergency loans made by higher education institutions; regrets the problems faced by international students as a result of the poor implementation of the new visa system; notes the need for additional, fully-funded, higher education places in 2010-11; calls on the Government to consider new ways to improve access to university for 2010-11; further calls on the Government to provide more information on its planned sale of the student loan book; and welcomes the idea of a cross-party student finance review to look at the long-term sustainability of the higher education sector, a fairer deal for part-time students and links with further education.
	We called for this debate at the very first opportunity since the House came back from recess because of the widespread and deep concern felt, I am sure, in all parts of the House about the financial uncertainties facing students who are starting university this year. Students, especially those starting university, should not have to face the financial distress, uncertainty and anxiety that many of them are, sadly, now confronting because of problems with the delivery of their student loans. I am sure that all of us will have received e-mails, letters and messages from students who are constituents of ours. I think of a student at Liverpool John Moores university who e-mailed me only yesterday. She said:
	"I find it diabolical that my loan is this late, that the Student Finance company are aware of the fact that I have a three year old, that I've got no money, I can't afford to pay nursery fees and frankly, I find it absolutely shocking and downright unacceptable to be ignored in this manner. I have NO money at the moment—I NEED my loan in order to live."
	That is the type of e-mail that we are receiving.
	We are also receiving messages from the National Union of Students and student unions across the country, which are aware of the problems. I should particularly mention the university of Wolverhampton student union, which has been exceptionally active on the problem. We are also hearing about it from universities and vice-chancellors. I shall quote a message that I received from the vice-chancellor of my local university, Portsmouth university, yesterday. He said that he has already had to give emergency loans and grants to 217 students, and said:
	"We anticipate that this will grow rapidly because students arrive with some money, which is now running out. Later this week we shall need to defer the first accommodation payment for those whose funding has not arrived, which is a significant cash flow issue. If one third of our students cannot pay their first instalment, we shall be short of £1 million until the payments are received."
	He goes on to make a point that many people are making to us:
	"Students are becoming very frustrated with lost applications, lost or not received duplicate applications, failure to alert the student of insufficient documentation until the student rings them and then being put to the back of the system on receipt of these."
	The situation is a shambles, and it is causing enormous distress to many students. Ministers have been trying to avoid responsibility for that by hiding behind the Student Loans Company. I very much hope that when we hear from the Minister for Higher Education and Intellectual Property in a moment, he will give a frank account of what has gone wrong and what he will do about it. Ministers cannot escape responsibility for what has happened. For a start, the system is one that they introduced; it is a consequence of a report that they commissioned, entitled, rather ironically, "Improving the Student Finance Service". In a written statement on 3 July 2006, the Minister's predecessor, the hon. Member for Harlow (Bill Rammell), announced the new system. Previously, assessments were made via local authorities. In that statement he said:
	"The student finance service needs to be as simple and accessible as possible to students, parents and graduates.
	As well as clearer information, faster decisions, timely payments and accurate repayments, the transformed service intends to provide taxpayers with better value for money".
	That was the promise three years ago. The reality, of course, is shockingly different. We are talking about a system that Ministers themselves designed. It is also a system whose complexity goes back to policy mistakes made in the late and not really lamented Department for Innovation, Universities and Skills—an extraordinary system in which three separate years of students each has a different regime for maintenance loans and maintenance grants, because the system has been changed year after year, creating extraordinary levels of complexity.
	When we look into the detail of what happened, we find that the papers that students send in are sent to Darlington. From Darlington they are taken by truck to Glasgow, where they are supposed to be electronically scanned in. We are told that the electronic scanners in Glasgow do not work properly, so the papers are put back on a truck and taken back down to Darlington, where much of the data is apparently being manually input because the electronic scanning procedures do not work. There is a helpline where the phone is rarely answered. E-mails go unanswered and the website is often inactive.
	I have to say to the Minister that the ghosts of SATS, education maintenance allowances and tax credits are hanging over this debate. He must take some responsibility for tackling the problem, especially as these difficulties were predicted months, if not years, in advance at meetings attended by senior officials of his own Department. The company forecast—we have this from the minutes of a meeting on 15 July 2008 attended by one of his senior officials—that 40 per cent. of all calls would be abandoned because customers would find the line engaged. The company forecast that it would be receiving three times as many e-mails a day as it was possible to process.
	The Department's response to these looming problems was a policy whose official name was—anyone would think I was making this up—minimising "avoidable contact" with students and their parents who were trying to get the loans and grants to which they were entitled. That is the story of incompetence, made worse by the complacency of some of the assurances that we were getting regularly that the situation was all about to get better. It did not particularly inspire confidence when the deputy chief executive of the Student Loans Company, challenged on the fact that documents appeared to be going astray and that the caseload was not being tackled, said that we should not worry because the documents were like lost car keys—
	"It's a bit like losing your car keys—you think you have lost them, but they are in the house somewhere"—
	which is not quite good enough for students and their parents.
	I wrote to the great panjandrum himself, the Secretary of State for Business, Innovation and Skills and just about everything else, on 11 September. His reply, as one would expect from Lord Mandelson, was prompt and courteous, but the distancing from the Student Loans Company made me think of a man carrying a noxious substance at arm's length while holding his nose. I could not have envisaged a Minister distancing himself more skilfully.
	The Secretary of State begins by saying:
	"I am told that this year the SLC has received a record number of applications".
	"I am told"—was he perhaps at a cocktail party where this was mentioned? Did he read it on flicking through his press cuttings and say, "Oh dear, look what's happening to student loans"? "I am told"—did a minion perhaps bring this information in on a silver platter for the Secretary of State to consider? He should have been told because he is the Minister responsible for an organisation that belongs to his Department and also to the Scottish Executive.
	The Secretary of State says:
	"I am told that this year the SLC has received a record number of applications".
	This year is the first year that the system has been operating. It did not operate in the same way in any previous years. This year is the first year when the problem has arisen because this year is the first year when Ministers' policy has been in operation.
	"I am told that this year"—
	I admire the skill. One can already sense the Secretary of State shimmying round a problem for which he ought to be held accountable. He goes on to say:
	"I understand the Company has told all students who applied before the relevant deadline that they will receive confirmation".
	We would love to hear from the Minister what this deadline is. There are various deadlines at the end of the application form. They are not on display on the website, and some of them are very early indeed. We would like to know what the deadline is.
	Lord Mandelson goes on to say:
	"As you know"—
	That is very encouraging; the Secretary of State knows that he and I share this understanding—
	"As you know, demand for university is up this year and this has put some pressure on the SLC's helplines."
	That means that people cannot get through. The response from the Secretary of State is exquisite in its ability to distance him from any practical responsibilities for which he and the Minister for Higher Education and Intellectual Property ought to take some responsibility.
	We would like to hear from the Minister a response to the following practical questions. First, how many students are still affected by the problem? There was a figure of 50,000 at one point. We have seen from a freedom of information request that there seems to be a gap between the 1,092,000 applications for student support across all three years and the 916,000 that have been processed. That would suggest a far larger gap of 175,000, so will the Minister please give us, first of all, an accurate up-to-date account of how many students are affected?
	Secondly, the Secretary of State says that everybody who applied before the deadline is okay, but what was the deadline? Was it last June, long before students had their A-level results and long before clearing had started? What was the deadline? Thirdly, when will the problem be tackled? When will it be sorted? Can the Minister give a guarantee and a date by which time students who are still facing uncertainty will get the information that they need about their grants and loans? In particular, can he guarantee that the problem will be solved before the process of applications in January starts? Some students start at university in January or February; they do not all start in September.
	Fourthly, what about the costs being incurred by universities? There is the access to learning fund, which many universities are having to use to help their students in financial distress, but the access to learning fund—whose size, incidentally, has already been reduced—was intended to help students who are under financial pressure through the year as part of the regular process of assisting students with modest incomes. It is not supposed to be spent in the first few months tackling a financial crisis not of universities' or students' own making. What financial support will the Minister offer to universities in these difficult situations?
	Fifthly—this is an area where the Department is adding insult to injury—will the Minister confirm that the main helpline number being used by students and their parents to get information is an 0845 number? Will he confirm that there are no numbers other than the 0845 number, and will he confirm that this is contrary to Ofcom guidance, which recommends that public bodies should not use such numbers exclusively? Will he tell us how much money is being made by the Student Loans Company obliging people to use an 0845 number and then leaving them hanging on, sometimes for a very long time?
	Sixthly, will the Minister undertake regular reports to Parliament, now that Parliament is back? Instead of FOI requests and suchlike, will we now have a regular update on what is happening?
	Those are some crucial practical concerns. So far the response of universities, students and the National Union of Students has been far more imaginative than anything we have heard from Ministers. Universities UK talks about universities delaying payment for university accommodation, which we know is going on. We know that universities and the NUS are prepared to write to private landlords to ask them to be sympathetic to students who cannot pay their rent, and that they are trying to help students with child care payments. The initiatives are all coming from universities and students. From Ministers we have heard nothing, and we now need to know what they are going to do.
	While the Minister is present, and as the motion ranges beyond the subject of the Student Loans Company, important though that is, will he also clarify the Government's position in two other areas that are of great public interest? The first is the sale of the student loan book, on which we had a statement in answer to an urgent question earlier this week. We believe that the Government had £6 billion of proceeds from the student loan book marked down for the future. It looks as if they now propose to increase that figure, so it would be very interesting if the Minister for Higher Education and Intellectual Property could tell us the new figure, because the sale of the student loan book was specifically identified as one item on which the Government would draw to meet their new target of an extra £3 billion in receipts. Does he still stand by the statement that he made on 14 July? He said:
	"The Government still intend to make sales from the student loan book, but it is clear that this should only be done at a time when we can get a good return for the taxpayer. For the time being, the market conditions do not allow this."—[ Official Report, 14 July 2009; Vol. 496, c. 373-374W.]
	Is that still his view of market conditions? If so, where does he expect the extra proceeds from the sale of the student loan book to come from? Any further light that he can cast on that would be helpful.
	The other area that is causing universities a lot of concern is the visa regime, which we refer to in our motion. We understand the need for tough and effective visa controls, but there are concerns from some universities about the scale of the delays that foreign students experience. Those people are incredibly important sources of revenue for British universities, but the registrar of the university of Warwick said:
	"UK visa officials appear to have replaced red tape with red barbed wire".
	Universities UK says that we are now
	"in serious danger of sending out a message that the UK does not welcome international students".
	The Minister will be aware of concerns about access to visas in places such as China, Hong Kong, Japan and Singapore. What measures are the Government taking to ensure that the necessary visa controls are implemented briskly and effectively and do not damage British higher education's reputation in the wider world?

David Willetts: I certainly will enlighten the Minister on that point, because we think that Ministers are in an odd position. In their amendment to our motion, they claim credit for the large number of students going to university this year, but of course some of that is down to the demographic bulge that was caused by the higher birth rate in the early 1990s. Some of it, sadly, is also down to the fact that young people cannot find jobs, so, when they receive the qualifications at A-level, they apply for university. I accept absolutely the argument that when the economy is in such a mess, if young people with A-levels that qualify them for university wish to go, it is for them a far better option than their simply going on the dole.
	At our party conference, we proposed an imaginative way of offering 10,000 extra, fully funded places for university students next year, when the demographic bulge will be at least as big and, sadly, unemployment will still be growing. For the summer of 2010, we propose a discount for early repayment of student loans, which would bring into the Exchequer extra cash that could be used to pay for extra student places. Our belief is that the extra student places— [ Interruption. ] The Minister for Further Education, Skills, Apprenticeships and Consumer Affairs mutters under his breath, "For those who are well off." The policy's crucial point is that the 10,000 extra student places will go to students from all backgrounds, and, in particular, we know that the best way to help students from modest backgrounds to get to university is to provide more places in total. That is the policy's crucial feature: it offers extra places at university with a clear, cash-flow benefit going to the Government in order to pay for it as a one-off measure in the likely student places crisis of 2010, which could, unless we take imaginative action, be at least bad as that of 2009.

Kevin Brennan: rose—

Peter Luff: rose—

David Willetts: I am grateful to the Chairman of the Select Committee, because that is a very important point.
	The Opposition are committed to improving opportunities for young people—

David Lammy: I beg to move an amendment, to leave out from "House" to the end of the Question and add:
	"welcomes the record number of students attending university or college this year meaning more students benefiting from higher education (HE) today than at any stage in UK history; commends the Government for its record levels of investment in HE, an increase of over 25 per cent. over the last decade compared to a 36 per cent. decline per student under the previous Government; recognises the Government's commitment to expanding opportunities to participate in HE, including an extra 10,000 opportunities this year in courses related to science, technology, engineering and mathematics subjects and 10,000 recently-allocated additional student numbers for 2010-11; commends the Government's generous student support package and regrets that this year the Student Loans Company (SLC) has been unable to provide the level of service students and their families have rightly come to expect; notes that 800,000 English-domiciled students have already had their applications for funds approved and that following additional Government support the SLC has allocated extra resources to deal with enquiries and processing; further notes that the vast majority of students who applied within the deadline will have received their money, that interim payments are available for students and the Government's Access to Learning fund provides help for students suffering financial hardship; further notes the significant contribution international students make to the UK, and believes that the new student immigration system is effective and fair; and further notes the Government's confidence in future economic growth which will enable a viable sale of the student loan book."
	I thank the Opposition for the chance to place on the record the Government's commitment to young people in higher education, which has clearly been one of this nation's great success stories over the past decade. I also welcome the opportunity to debate with the hon. Member for Havant (Mr. Willetts). I am fast learning that he rarely misses the opportunity to overstate his case. I think back, for example, to our exchanges before the recess, during which the hon. Gentleman confidently predicted the collapse of the clearing system this autumn—a collapse, needless to say, that never happened. Perhaps it is his reputed two brains that account for the tendency to provide twice the level of cynicism and hysteria every time he rises to speak at the Dispatch Box. Either way, I thank him, because on any analysis, the Government have a strong record to discuss.
	The story of more people going to university, from a wider variety of backgrounds, to enjoy properly funded higher education is clearly a positive one. We do not pretend that nothing ever goes wrong. Indeed, the main subject of the Opposition motion today is that something has gone wrong in relation to the Student Loans Company, and in a few moments I shall turn to that issue. But let the House be under no illusion: my hon. Friends and I do not fear a debate about our record; on the contrary, we welcome it. Higher education has always provided a stark illustration of the difference between the Government's vision and that of the Opposition, and I, like the rest of the country, wait impatiently to find out the suite of policies that the Opposition propose.
	I know, for example, that the hon. Gentleman has often stated his commitment to widening university participation. If only those wise aims were matched by wise means. Instead, we have heard a succession of sketched-out proposals that have vanished into thin air like smoke from the Bullingdon club's after-dinner parties. The hon. Gentleman has described the latest proposals in instalments over the past few months. One idea was to charge 8 per cent. interest on student loans. It is hard to think of a more effective deterrent to ordinary working-class students than that.

David Lammy: He is patently wrong, as my hon. Friend suggests; if he picks up this week's edition of the  Times Higher Education, he can see the international rankings that demonstrate that that is not the case. It is not appropriate for someone who suggests that he wants to stand at this Dispatch Box and lead on higher education to talk down what our universities are doing.

Mark Pritchard: Is it not the case, though, that not content with giving this nation a huge overdraft, the Government's failure to take action over the Student Loans Company means that many of my constituents are themselves suffering huge overdrafts—not only the students but the parents? They will be disappointed and surprised that, instead of mocking the very serious points made by my hon. Friend on the Front Bench, the Minister is not a little bit more contrite and humble and offering an apology to the people of Shropshire, who are suffering real financial hardship.

David Lammy: I will discuss the Students Loans Company in a moment. The people of Shropshire will be deeply disappointed that those on the hon. Gentleman's Front Bench propose a £610 million cut in our budget. How would that support their endeavours to send their children on to higher education? That is the question that he should be asking.
	The hon. Gentleman should also ask why the hon. Member for Havant proposes—we heard it again this afternoon—a 10 per cent. discount for graduates whose parents are rich enough to pay off loans early. That is clearly another equivalent to the Opposition's inheritance tax cut for some of the wealthiest estates in the country. He said that he would fund an extra 10,000 places, but that is money that he would not have to spend, and that the Government certainly do not have to spend, because the Government borrow the money from the banks in order to meet those tuition loan repayments. His proposal would therefore cost Government an additional £240 million across those academic years. Where would that money come from? What kind of a way is that to run the economy? How is it that he has failed to add up properly and proposed a policy that would actually plunge us into further debt?

Dari Taylor: I had hoped that the hon. Member for Havant would give way on that point. Does my right hon. Friend acknowledge the veracity of the statement from vice-chancellors—perhaps not all, but certainly some—when they say: "If we are to have a further 10,000 places, is someone going to tell us where the classrooms and lecturers are coming from?" Those are very serious considerations.

David Lammy: My hon. Friend is absolutely right. She recalls a moment in time during the early 1990s when the Conservatives increased participation but lowered the unit of resource—class sizes grew and facilities were poor. They failed to invest in research, and we subsequently had a Save British Science campaign. We cannot go back to that. She is right to remind the House of the hard choices that we face in government as we, by necessity, manage growth in the system.

David Willetts: We have heard a quite extraordinary set of allegations in the past 10 minutes. There is no Conservative policy for an 8 per cent. interest rate for students, there is no £620 million cut, and the 10,000 extra places would be properly funded with extra cash going to the Exchequer. I suggest to the Minister that in the remaining 10 minutes of his speech he focuses on a practical problem facing students and their families now and offers some explanation of what has gone wrong with the Student Loans Company system and what he is going to do about it.

David Lammy: It is my speech and I will make it as I want to.
	The hon. Gentleman's constituents will also be concerned that according to today's edition of the  Evening  Standard, the Conservatives are saying, in advance of an independent review, that students should pay £7,000 in fees. That is what they are saying to the country. That is extraordinary given that we have said that we will set up an independent review and we have sought to consult Opposition parties on it. I was surprised to read that proposal before I came into the Chamber.

David Lammy: On the sale of the student loan book, the hon. Member for South Holland and The Deepings (Mr. Hayes) supported that measure in this House back in 2007, before the global economic crisis made raising money from assets a necessity, as it is now. In March, I said clearly that the time was not right and we would suspend that sale. It is now October. As the Prime Minister, the Secretary of State for Department for Business, Innovation and Skills and the Chief Secretary to the Treasury have made clear, following the progress that Volkswagen and Lloyds have made as regards the securities market, we will test the market. We will of course seek to get value for money on behalf of the taxpayer, but it is right that we test the market to see whether we can make that sale possible.

John Hayes: The Minister is right. We support the principle of selling the student loan book—when the time is right. He will remember that my hon. Friend the Member for Reading, East (Mr. Wilson) and I made it absolutely clear at the time that a value-for-money criterion was critical. Following today's debate, will he commit to making that funding criterion—a framework that he must have in the Department; he would not be diligent if he did not—available to the House so that we can see on exactly what terms the loan book will be sold?

David Lammy: As the hon. Gentleman knows, the Treasury will make that assessment on the basis of the market as is appropriate at the time.
	Let me turn to recent events at the Student Loans Company. We have already heard something about that from hon. Members. This year, the whole university applications and admissions process has faced unprecedented demand brought on by the effects of the recession. Unemployment, especially youth unemployment, has risen, and it is clear that this has caused many more young people to apply to university, and for student support, than might otherwise have done so.
	Faced with these pressures, the Student Loans Company has fallen short of public expectations in responding to increased demand. While it is true that, as at this moment, 640,000 students in England have been paid by the SLC this year—more people than ever before at this point in the year—I share the concern of Members in all parts of the House that a minority of students have not received their funding in good time ahead of the new academic year. That in unacceptable and falls short of what the public can expect.
	This year's problems have had a profoundly regrettable effect on individual students and their families. Even when they have not led to financial hardship, they have undoubtedly caused worry and frustration, particularly for parents attempting to get through on the phone lines. The company's chief executive has already publicly apologised for the difficulties that customers have had in contacting it. Its chairman has also apologised to customers for their experiences this year, and I repeat that I, too, am sorry for what parents and students have experienced. I also share Members' frustration at the disappointing customer service provided by the Student Loans Company. Many students and parents have not been able to get through to speak to an adviser and find out about their application. Others have been confused about the process and what is happening with their application at an important time in their life.
	In anticipation of increased demand, I provided the SLC with all the resources that it asked for in this financial year—an additional £6.9 million—to fund increased costs to the organisation. Problems began to emerge in early September, and I met the chief executive and deputy chief executive of the SLC on 8, 10, 14 and 24 September to express my concern and ensure that action was taken. To support the SLC further, I made available an additional £230,000 of funding in September to help put a number of measures in place. They included a 70 per cent. increase in the number of phone lines, recruiting additional staff to answer phones, paying more staff to work overtime, increasing call centre operating capacity by about 35 per cent., reminding students and parents that they could check the status of their application online and improving answers to the most common inquiries.
	The SLC has now stated its target that anyone who submitted an application on time, with the correct information, will receive their full payment by the end of October. It is now vital that it learns the lessons of this year and plans for improvement next year. I have received a letter from the chairman of the SLC setting out his initial view of what happened in the first year of the transition to a fully centralised system of financial support for students in England. However, there needs to be a thorough consideration of the matter. To that end, I have invited Professor Sir Deian Hopkin, the former vice-chancellor of London South Bank university, and Bernadette Kenny of Her Majesty's Revenue and Customs to bring external scrutiny, expertise and challenge to the company's review of lesson learned from this year and its preparedness to meet the challenges of next year. The SLC itself is on record as acknowledging the need for such an exercise, but I am determined that the process should involve the external challenge and expertise needed to provide a frank assessment of what went wrong and a series of thorough proposals for the future.

David Lammy: The deadline was at the end of June. The hon. Gentleman will appreciate that many people who apply for student finance do not ultimately go to university. Others apply solely on the basis that they have entered the clearing process. With the increase in demand this year, there was a huge growth in the number doing that. The SLC says that it is currently receiving about 5,000 applications every week, but he will understand that not all those applications result in students actually going to university. The company has to process them, but some people are assessing what their finances might be if they went to university, and some are not successful in getting to university at their first attempt.
	There has been a big increase in the number of applications. In fact, 830,850 applications have been processed, which is 49,000 more than last year. There are 77,000 applications in processing, and we understand that 71,200 students are not eligible or have withdrawn. It will be a moveable feast over the course of the next few weeks as students enter university. Of course, some students apply at that point, and this year there has been a growth in the number doing that. Some enter university and decide that it is not for them and drop out in the early months of their course, or switch institutions.
	There are complexities to the numbers, but of course I do not withdraw from what I have said—that the standards of service that the public have come to expect from other big call centre operations, be they NHS Direct or HMRC, have not been met. The review will consider governance, programme management and processing, and I want it to report quickly so that its recommendations can be incorporated into the SLC's preparation for next year's processing.

David Lammy: There are a range of reasons why students drop out of university, and the hon. Gentleman will be aware that through the widening participation component of the block grant that we make to universities, particularly those that specialise and have considerable expertise in supporting more vulnerable students and those from more deprived backgrounds, we provide money that supports the retention of such students at university. As the hon. Member for Havant said, we also provide £45 million to our universities through the access to learning fund, to support students through what are normally called "hardship funds". Those funds are being drawn on to support students at this time in particular.
	It is important that we bear in mind that it is 14 October, and most universities' terms began two weeks ago. We are at the beginning of the process. However, the situation has not been good enough, the demand was not anticipated, there have been problems with scanning and technology and trialling has not been effective enough. Too many people have not been able to get through on the phone, and automated e-mails have driven people to want to phone, increasing demand even further. That must be the subject of a lessons learned exercise.

David Lammy: That is a nice try, but as I have said before, the hon. Gentleman will be aware of his party's commitment to £610 million-worth of cuts and the effect that that would have at this time.
	The SLC's current operational difficulties are unfortunate, and I have described to the House the measures that are in hand to deal with them to ensure that they are not repeated. However, they should not distract us from the real issue, which is the Government's success in building our world-class higher education system, our resolve in ensuring that the system is truly fit for the challenges that we will face as a nation in future, and our unswerving commitment to building aspiration among young people from ordinary and, especially, underprivileged backgrounds, for the many benefits that higher education brings.
	That is in stark contrast to the Conservatives, who offer not a renaissance, but a risk that the country cannot afford. They asked to be judged on how they treat the poorest in society, only to offer unworkable and wasteful discounts to students from the richest families in the country, and they have nothing to say on social mobility and widening access to university. They promise to peg down debt, only to make spending commitments that they cannot afford. Having promised people that they have changed, they revert back to a Thatcherite core, opposing the help that businesses need to stay solvent, the help that families need to stay in their homes, and the help that young people need to invest in the future.
	The past few months have reminded us that the Conservatives are in opposition for a reason. Neither credible nor compassionate, they offer nothing more than the echoes of their discredited past. As the country emerges from the economic shock of this century, what people need, especially our young people, is not hollow rhetoric, but support, and opportunities to contribute to this country's renewal.

Stephen Williams: Many of us will have a sense of déjà vu today. Just before the summer recess, we had many debates and discussions about the crisis and shambles over which the Minister of State was at that time presiding—the lack of places in higher education to meet demand. This summer, on behalf of my party, I covered A-level results day. In previous years, the debate has been centred on standards. This year, after seeing television pictures and photographs of elated students receiving their results, we saw some heartbroken students who had realised that their place was not guaranteed and who had no idea what was going to happen to them in clearing. We will not know until next week, when UCAS releases its final figures, the status of such applications and how many people's success at obtaining results has led to disappointment at not obtaining a university place.
	Today, however, we are concerned with yet another shambles presided over by the new Department. According to various press reports in the past few days, at least 100,000 students are yet to receive confirmation of their grants or maintenance loans. It has also been reported that first-year students have been hard hit. According to information released to the BBC under a freedom of information request—it is a shame that the BBC had to obtain the information that way and that the Student Loans Company or the Government were not more open with students and their parents—28 per cent. of applications by first-year students had not been processed by last week.
	We know that universities are able to be flexible, particularly with first-years, regarding, for instance, hall fees, which after all are entirely under university control, but what about students who are having to pay private landlords, rental deposits or the finding fees that letting agencies demand? Hon. Members who represent university constituencies, including my hon. Friend the Member for Manchester, Withington (Mr. Leech) and I, will know about those fees. What about students who have child care considerations and fees to pay? They cannot at the moment be certain that they will have access to the money that they need to meet those obligations.
	I am especially concerned about non-traditional students who have accessed university for the first time. On Monday, our first day back following the summer recess, it was my great pleasure to host a reception in the Members' dining room for the Helena Kennedy Foundation, at which Baroness Kennedy gave awards to people who have received bursaries from the foundation. Many of them are from very difficult backgrounds and were going to university for the first time. Following my intervention on the Minister he addressed the fact that people drop out of university. Many who are going to university for the first time drop out because of pressing financial circumstances, and it would be a tragedy if the drop-out rate increased because people's fears of the financial pressures of accessing a degree were realised.
	This is the first year that the SLC has had responsibility for handling grant applications; many hon. Members will have gone through the old local authority process. The hon. Member for Havant (Mr. Willetts) has already referred to that most unfortunate quotation in yesterday's edition of  The Guardian of Mr. Derek Ross, the deputy chief executive of the SLC, who said that the problem was akin to losing one's car keys. We have all done that at some point and it is a personal inconvenience, but Mr. Ross has mixed up personal inconvenience with the financial hardship and uncertainty faced by others. I hope that those remarks are withdrawn and, indeed, apologised for.
	Why were the problems not foreseen? The SLC should have prepared for its new responsibilities. As I understand it, consultation on moving to the new system took place three years ago, in 2006. It was welcomed by many at the time, including the National Union of Students, because it was a move away from the fragmented system of local authorities processing applications using different procedures, which produced different outcomes up and down the country, to a uniform system. The NUS was given assurances that the SLC would prepare for the day and time when it took over responsibility, but it is now clear that those assurances were not worth much.
	The SLC should also have foreseen that there would be a rise in applications this year. UCAS released statistics at various stages in the past academic year, and we have known what the situation would be for some time. We said in the debate in the summer that the crisis of access to student places should have been foreseen. Likewise, the SLC should have foreseen that it would have to deal with a greater volume of applications than in prior years. In addition, the uncertainty over the number of places meant that there were bound to be more late applications for financial support. Those things could have been foreseen and they should have been planned for.
	It should be acknowledged that the Minister has expressed his disappointment with the situation, but this is the fifth fiasco that has been presided over either by the Department for Business, Innovation and Skills or by the former Department for Innovation, Universities and Skills. The right hon. Gentleman is the sole survivor from that short-lived Department. We have had the further education college capital expenditure programme fiasco, delays in education maintenance allowance awards, confusion over the funding of sixth-form places and the uncertainty this summer over higher education places.
	The Minister told us what he is doing to get the SLC to learn lessons and I welcome what he said about getting a review under way, but it is vital that those lessons are learned so that we do not go through the same again in 2010. I welcome the appointment of Deian Hopkin, a former vice-chancellor, whom I met on many occasions at South Bank university, and whom I like and respect very much. Will the Minister tell us when the review will be complete, so that lessons can be learned and so that new processes can be put in place in time for next year's applications? What will the Department do to help universities that are giving short-term, emergency loans? The Minister referred to the access to learning fund, but he neglected to say that the fund has been cut by 30 per cent. in the past four years, between 2005 and 2009. What will he do to enable universities to give ongoing support to individuals who have been affected by the delay in financial support—an upsetting start to their university experience—so that they are able to continue their studies and the danger of them dropping out is ameliorated?

Barry Sheerman: I apologise for missing the start of the debate, but Committee duties delayed my arrival in the Chamber.
	The hon. Gentleman was a member of the Education and Skills Committee, and he mentioned confusion. I am confused about whether the Liberal Democrats now believe in variable fees—top-up fees as they are called—or whether they have changed their minds? Is it that their leader does not like them, but the party does?

Stephen Williams: It was a pleasure to serve on the Education and Skills Committee and the Children, Schools and Families Committee under the hon. Gentleman's chairmanship, and I learnt a lot from that excellent Select Committee process. If he is patient and stays for the rest of my speech, he may find that his question is answered.
	The sixth shambles over which this Department has presided—the problems faced by international students—is referred to in the motion. On this issue, my sense of déjà vu goes even further back. It was the subject of the first early-day motion that I tabled as a new MP in May 2005 and the second speech that I made which was on the Immigration Bill. I spoke specifically about the difficulties that Bristol university and Universities UK had brought to my attention. They anticipated that the changes in the visa regime in that Bill would lead to problems for international students. The then Home Office Minister, the right hon. Member for Harrow, East (Mr. McNulty) who is, as we all know, gentle and kind, especially to new hon. Members, told me twice that I was talking rubbish and more rubbish—

Stephen Williams: Perhaps he is studying a letter carefully.
	Four years on, we know that there have been massive delays in processing these visa applications. International students are crucial not only to the financing of higher education in this country—bringing in some £4 billion of fees a year—but to the intellectual sustainability of many courses. Many such courses, especially those in shortage subjects such as engineering, would not be viable without the physical presence of international students. Anything that blocks their access to study in the UK is surely to be regretted, and the Minister needs to intervene urgently with his Home Office colleagues to sort that out.
	Many of our services depend on the contribution made by overseas graduates, and the most obvious example is medicine. Will the Minister give an assurance that medical students who have already embarked on a degree course will be able to complete the post-graduate stage of their qualification and will not be subject to further variations in their visa conditions?
	I turn now to the short-term future of higher education, rather than today's problems. Next year, there must be no repeat of the debacle this year. We know now that the number of 18 and 19-year-olds in next year's cohort will rise again, just as we knew it would this year. We know now that unemployment will continue to rise in the short term, and as a result—as we know from all previous recessions—more adults will look for shelter in higher education.
	The Conservatives have proposed a fees discount to fund places in higher education, although the hon. Member for Havant was reticent about it in his speech. That may be attractive as a short-term fix, but it is another example of the Conservative party seeking to make life more comfortable for the well-off, especially if it were to be part of their long-term thinking. We will seek clarity on that point in the run-up to the general election.
	In the longer term, we agree with the motion when it says that there must be a level playing field for part-time students. That was the subject of the last report that the old Education and Skills Committee produced on international students, and one of the last recommendations that the Committee made. My party passed a resolution at our conference in March that said that we would also abolish the fees for part-time students. However, we also envisage that in future higher education will see a greater emphasis on foundation degrees and a strengthening of the role of further education colleges, as well as more emphasis on the skills needs of the nation, especially in STEM subjects—science, technology, engineering and maths. I have mentioned that issue many times in such debates. We would recommend a national bursary scheme to fund students taking the STEM subjects that are essential for us to achieve a low-carbon economy.

Stephen Williams: The hon. Gentleman will know that the leader of my party was referring to the desperate state of the nation's finances and the reluctance of the present Government or the Conservatives to face up to the cuts that have to be made if we are to balance our national books, or to give any specific examples of how those cuts could be made. At least my party has put forward some specific examples, such as the Trident missile programme which no longer needs to be renewed and which would release billions of pounds to be invested in other priorities.
	I mentioned the skills that we will need for the low-carbon economy that must be part of our future. I just want to draw the House's attention to some good practice. For instance, in Cornwall an array has been built offshore to take advantage of the tidal energy. Combined Universities in Cornwall has introduced a new degree in renewable energy—the first such example in the country—and a foundation degree in renewable technologies, and is working with others to provide technical-level skills. We need much more of that happening in our higher and further education institutions.
	I cannot agree with the penultimate sentence of the motion, which states that this House
	"welcomes the idea of a cross-party student finance review to look at the long-term sustainability of the higher education sector".
	That is not because I oppose trying to reach a consensus on the funding of higher education or other long-term issues that face this country, such as long-term care for the elderly or pensions. It is because the fees review in higher education was specifically promised in the Higher Education Act 2004. Lord Mandelson has so far dodged announcing that review, although I congratulate the hon. Member for Havant on getting a reply to his letter from Lord Mandelson. My own experience has not been so happy. We were due to have a meeting to discuss the fees review, but it was cancelled at short notice. It was replaced by the promise of a phone call at a very precise time—and at that very precise time the Minister's private secretary called to say that he no longer had the time to speak to me. So I am none the wiser about Lord Mandelson's ideas on cross-party working on the future of higher education, or more critically, when the review promised in the Higher Education Act will commence or what its terms of reference will be.
	It is evident that a cosy consensus is building up between Ministers and Conservative Front Benchers, because they do not want this debate to take place in the run-up to the general election. They want to stifle that debate and ensure that the conclusions of the report are kicked into the long grass in the field beyond the next general election. The Liberal Democrats believe that students deserve better than that and that higher education should be a key part of the debate between all three parties at the next general election. We will certainly be affirming, and reaffirming—

Natascha Engel: It is a pleasure to follow the hon. Member for Bristol, West (Stephen Williams), although I disagree profoundly with a couple of things that he said. I think that the whole House agrees with the first line of the Conservative motion:
	"That this House congratulates those who have secured a higher education place for 2009-10 and wishes them well in their studies".
	I shall ignore the rest of the motion at this point—I wanted to start with a consensus, before breaking it.
	I want to focus on the issue of widening participation, by which I mean giving access to higher education to as many people as possible from as many different types of background as possible. Within that, I include further education—any education after school that prepares people for the world of work. Traditionally, people from more privileged backgrounds have had better access to higher education than those from less privileged backgrounds. I think that we all agree on that. Since 1997—this is where I really disagree with the hon. Gentleman—we have had a very proud record of achieving far better and wider participation in higher education.

John Hayes: rose—

Natascha Engel: Ha-ha! But if the hon. Gentleman will wait, I shall provide my own statistics. In terms of wider participation and access for all, 2007-08 saw a rise of 20 per cent. since 1997 and an extra 2 million students in higher education. That is a massive number, although we have some way to go. However, I wanted to start with something positive and say that, without a doubt, we have widened participation and opened up access to higher and further education—in particular, higher education, which has traditionally been a bastion for people from more privileged backgrounds.
	I want to mention briefly the Student Loans Company fiasco, which is an issue that has affected anyone with students in their constituency. Although nobody is trying to justify what has happened with the company—it must never happen again—it was more devastating for students from backgrounds without money or without anyone to make them a loan to ensure that they were all right for the first couple of weeks at college. Furthermore, the situation has been very frightening for those not used to the environment of higher education. I hope that that is appreciated and that the situation that has arisen does not do so again.
	I turn to the Aimhigher programme, which has been very successful in accessing students and children from backgrounds where people would not normally think about proceeding to higher education. That is the big issue about access to higher education: if someone comes from a background in which parents and other family members are not used to people entering higher education, they tend not to aspire to it. They think that university is not the sort of place for them, which cuts them off early on—before they start out on their careers—from any number of higher earning and status vocational careers that those from more privileged backgrounds take for granted. I include being an MP among those careers. We still have some work to do. However, programmes such as Aimhigher do some amazing outreach work in secondary schools—some work is also being done in primary schools. The mentoring is fantastic, and it involves people who come from less privileged backgrounds talking to children in school and working with families to ensure that people understand that university is a place for everybody, that it is not closed to anybody and that everybody should be allowed to go. When it comes to social mobility, widening participation and giving access to everybody, that is a really important point.
	The increase in the number of over-40s entering university is very interesting. It gives people the opportunity to enter higher education, which they might not have had growing up—again perhaps because they came from backgrounds where it was not the sort of thing that people did. Later in life, they now consider re-entering education, going to university and getting a degree to be the right thing to do. That is a real success story.

Natascha Engel: Would the hon. Gentleman like to intervene, instead of shouting?
	I chair the youth affairs all-party group where the 16-hour rule is a particular issue. It is an issue particularly for younger people—19, 20 and 21-year-olds—who have had a bad time in the past. I am talking about ex-offenders, runaways and people who have been through the care system who are on benefits and receiving support, but who now think that they perhaps want to go into full or part-time education.
	Those on jobseeker's allowance who want to study part time— [ Interruption. ] My speech is so interesting, Opposition Members should listen—I listen to theirs. Those who want to study part time have to pay their tuition fees up front, and that applies whether they are on jobseeker's allowance or not. Part-time students still have to pay those fees up front, which discourages people from studying part time. It is important to look at that in targeting those people whom we want to take up studying.
	My hon. Friends will be aware of this, but the 16-hour rule means that jobseeker's allowance claimants cannot study on further education courses that take up more than 16 hours a week or, for those under 20, 12 hours a week. That seriously needs to be looked at. I have mentioned the issue time and again, and I would be grateful not just if someone said that they would look into it, but if they did something about it.

David Willetts: rose—

Barry Sheerman: Don't give way—he was talking.

Natascha Engel: I thank the hon. Gentleman for that intervention. The 16-hour rule needs to be looked at seriously, because it definitely discriminates against those who come from less privileged backgrounds. Those on jobseeker's allowance or housing benefits tend not to be those from the most privileged backgrounds in our society, so it is critical that we look into the 16-hour rule to help widen participation.
	I will draw my remarks to a conclusion in a second, but I want to reiterate that record numbers of state school pupils aspire to go to university. That is critical to what this Labour Government have done since 1997—it is about widening not only participation, but aspiration. We have record numbers of children and young people aspiring to go to university from poorer backgrounds. It is critical that we ensure that young people are given the skills to get them through the recession and out the other end, taking a full part in both higher education and the world of work.
	One interesting statistic, which counters the one that the hon. Member for Havant (Mr. Willetts) mentioned earlier and refers to a gap that we need to close as quickly as possible, is that 79 per cent. of children from working households—that is, households where there are working parents—aspire to go to university. That figure drops to 66 per cent. among children who come from homes where there is no working parent. That gap in aspiration is something that all of us in the House, no matter what our political party, must aspire to close. I want to finish on that point. Since 1997, this Labour Government have had a long and proud record of widening participation. We should all work towards widening it even further.

Chloe Smith: I am grateful to you for giving me the opportunity to take part in this Opposition day debate and make my maiden speech, Madam Deputy Speaker. I also thank the hon. Member for North-East Derbyshire (Natascha Engel) for her comments.
	As this is my first speech, I want to pay tribute to Dr. Ian Gibson, the previous Member for Norwich, North. He was a dedicated constituency Member whose tradition of independence and plain speaking I hope to emulate. He was known locally for his work on science, as I understand he was here in the House, and for sticking up for the people. Although I do not enter this place as a scientist, I certainly intend to stick up for all my constituents.
	There has been a Norwich, North seat since 1950, but the city of Norwich has been represented in Parliament since 1298. I am proud of Norwich, North, with its one foot in the city of Norwich and its other foot in surrounding parishes and beautiful Broadland. We have a history stretching back to Roman times, and colleagues in the House may already be familiar with Norwich's trading prominence in the intervening centuries. We are known for industries such as chocolate, mustard, wool, shoes, financial services and now modern technologies, including biotechnology and engineering. We have a high proportion of small and medium-sized firms, and I applaud all those in Norwich who choose to take a risk and build their own businesses.
	Norwich also has cultural prominence. Underpinning our current vibrant arts scene, we can also claim the writing in English—or middle English, to be more specific for any other students of literature in the House—of the first book by a woman. On the political side, movements have often gathered on Mousehold heath in my constituency, including the Chartists 170 years ago and Robert Kett's followers before that.
	We are also known for the Canaries' best efforts to stay up the leagues. Norwich City football club is currently prospering in division one. Given that the last full match that I saw in person resulted in Norwich losing 7-1 at home to Colchester—is the hon. Member for Colchester (Bob Russell) here? No, he is not—I think that, in the interests of the club, it may be wise for me to stay away until promotion is fully secured. For any real aficionados of Norfolk's footballing heritage, I draw hope from a reputed draw with Arsenal by the village football club of Thorpe St. Andrew, only as recently as 1894. It remains a shame to this day that the parish could not afford to pay the travel costs for the match replay in London.
	In addition to its fine urban history, Thorpe St. Andrew is but one of the parishes that give present-day Norwich, North so much of its character and feeling. According to local sources, Sprowston is the largest parish in Norfolk—I look forward to receiving letters claiming otherwise, which I shall happily forward to the parish council. Old Catton can claim further cultural merit. In Catton hall, it has the location of the first commission for landscaping by Humphrey Repton. Equally importantly, Old Catton's history exemplifies the tradition of independence in the people of Norfolk, among whom I count myself. According to local historians, the parish had
	"a high proportion of freemen in the Domesday record which is typical of Norfolk".
	The Domesday Book also lists other parishes in Norwich, North, including Hellesdon and Taverham, where, in its Victorian heyday, a paper mill produced half of all the paper used to print  The Times. Drayton, the final parish in Norwich, North, has another literary claim to fame. During the 15th century, the village was in the possession of Sir John Fastolf, a prominent soldier who, it is claimed, gave his name to Shakespeare's character Falstaff.
	In researching this speech, I found that some of the things that trouble the people of Norwich, North have not changed in decades. For example, although I was not sworn in as a new MP until this week, over the summer my postbag contained a wealth of letters complaining about a sewage farm located just in the constituency of my hon. Friend the Member for South Norfolk (Mr. Bacon), but none the less pungent for that. I have found references to residents complaining bitterly about the very same sewage works from as early as 1933.
	I sincerely hope that other problems that are raised with me will take less than 70 years to be resolved. For example, I look forward to working over the next nine months on NHS facilities, transport, housing and more. I am already working on behalf of those constituents who face problems with social housing. My predecessor talked eloquently about Norwich's housing during his maiden speech in 1997, but the problems have not diminished since then. It is a personal priority for me to focus on the improvement of the stock and service for local council tenants.
	Finally, the backdrop to my first few months as the Member for Norwich, North is a bleak one for many of my constituents, for their jobs and for their businesses. My constituents are struggling in this recession. In this Opposition day debate on higher education, I must highlight the importance of the educational sector to the local economy in Norwich and Norfolk. Not only as a local MP, but as a Norfolk girl who might be said to have made good, I look forward to addressing the graduation ceremony at City college, Norwich, on Saturday. I shall applaud the many young people who have gained qualifications—as does the motion before us today—and I shall praise the work of the tutors and others who enable their success. However, I also sympathise greatly with the college for the deep confusion that it has experienced through the Learning and Skills Council's capital crisis. Many of my constituents are already losing out in the chaos, and we may all lose further if the college cannot recoup the £3 million already sunk into plans encouraged by this Government.
	Finishing on today's higher education topic, I pay tribute to the university of East Anglia, which is the former home of my predecessor, although it is in the constituency of the right hon. Member for Norwich, South (Mr. Clarke). It is notable for working with local partners, the city and the county. The Norwich research park is taking on today's great environmental challenges, and Professor Tim O'Riordan of the school of environmental sciences is our fine city's sheriff this year.
	Local employers, many of which I have sought to meet since my election this summer, want to work with local institutions such as UEA and the City college to ensure that the education offered reflects the needs of people and businesses in Norwich and Norfolk. That requires clarity and honesty on finance. I look forward to working with all involved back at home to realise higher education's contribution to economic recovery and growth, as I look forward to working with colleagues in this House to see the many good ideas expressed in this debate brought to fruition for my constituents and theirs.

Dari Taylor: It is a pleasure to follow the hon. Member for Norwich, North (Chloe Smith). I warmly welcome her to the House, as do all hon. Members. It was a pleasure to listen to her speech, which was young, enthusiastic and knowledgeable—characteristics and qualities that are warmly welcome here. It is my belief that she will represent her constituents with care and professionalism. I congratulate her, and I am delighted that she is taking her seat.
	I believe that the Government have an excellent tale to tell on higher education, in regard to its expansion and its development. I live in the northern region, where we have five high-status universities, all with developed or developing relationships with further education, and with schools and their communities, supporting the growth of student numbers and the diversity of subject areas. We have seen the development of foundation degrees and the way in which universities and further education are supporting a recruitment exercise of youngsters and middle-aged people—often on low incomes—into higher education.
	The activity of persuading young and older people that they have talent and can enter higher education takes a serious effort, as does getting them to believe that they can read for a degree. The language involved can seem different and perhaps a bit peculiar. There is a serious challenge involved, but I am delighted to say that the universities in the northern region are doing an excellent job. On my doorstep are the universities of Teesside, Sunderland, Northumbria, Newcastle and Durham, and in my own constituency I have the Queen's campus, which is part of the university of Durham.
	We are talking about some important issues today, including visa control, the student loans facility, and the way in which the additional 10,000 students are being added. It is important for me to remind the House—if it needs reminding; perhaps it does not—that we have seen a staggering increase in student numbers over the past 12 years. In my own region—Teesside university is within a mile of my constituency—we have seen a growth in student numbers from about 14,000 to 28,000 youngsters. At Queen's university, Durham, the student numbers are now topping 15,000. This is a staggering increase. It should not surprise any of us that this also presents enormous problems for those administering the student loans and grants, but I believe that the figures speak for themselves.
	We would not have seen that increase without the high-calibre leadership of vice-chancellors such as Graham Henderson and his staff, all of whom offer a staggering range of qualities. In that, it is not just, as it was in my day with the universities of the '60s and '70s— [Interruption.] Yes, I am afraid that it was those decades, but I am proud to say that I was one of the flower power people at that time.  [Interruption.] I may be an ancient flower power person now, but it is still there with me.
	When the university of Teesside says, "We must encompass seriously more within our region if we are to develop the quality and diversity of education," it follows it up by creatively and innovatively developing collaborative work with large companies. I shall specifically mention Rolls-Royce, but that is not the only company. Professor Simon Hodgson, dean of the school of science and technology, is developing technologies for low-emission aircraft engines for future generations—just what we want if we want to fly. That piece of research is extraordinarily important and I am delighted to say that it is being done on my doorstep.
	It will not surprise anybody when I say that my pride does not stop there, as the university of Teesside has been shortlisted for the title "university of the year" in the category of the outstanding employer engagement initiative on the basis of its work with the chamber of commerce. This is a golden field of older, mature and experienced people—for many of us, of course, older means over 30. For me, it means seriously over 60, but I am prepared to move the older category along the line. The chamber of commerce is telling its people that they have so much to give, so they should give it. Some of those involved are teaching within the university and others are listening.
	We should not for a moment understate the importance of the opening comments of the hon. Member for Havant (Mr. Willetts) speaking for the Opposition or of the Minister speaking for the Government side, and we must recognise that the student loans facility needs to be seriously improved. In saying that and acknowledging the problem, it is important to celebrate the expansion of our universities and the increase in the number of young people—particularly those from low-income families—attending them.
	I was born in a two-up, two-down house in the Rhondda valley and from the whole street of terraced houses, there were probably only five families out of 90 that sent their children to the grammar school. My father was under no illusions when he said, "You will learn, my girl"—and I did; I had no option. When I said, "How do you know we are bright?", he said, "I am telling you that you are bright, because the more you work at it, the better your intellect will develop".
	It is worth noting that that sort of statement—too many years ago for me to want to inform the House, but well over 50 years ago—is still being said today to our young people. It is not just important to say, "You have got talent"—although we need that vision—as we also need a strategy. The strategy that the Government have developed has been invaluable. We have seen education maintenance allowances to persuade people to stay in education post-16, and then the Aimhigher programme, which is clearly changing low to high aspiration. That is a struggle—a mammoth struggle—but it is taking place.
	The universities of Durham and Teesside are the two I know most about; they are out in their communities, working with schools serving low-income areas. They work seriously hard with such low-income groups, and I am delighted to say that they are producing some serious results. Primary schools in the poorest areas of Teesside are involved in the graduation ceremony—guns and all—in the university of Teesside. Nothing is too good for this lot. We are trying to persuade them to realise that if they have the talent, which they have, it needs working on; we are there for them and will help to ensure that their talent is developed.
	I have spoken about the need for a strategy and I have mentioned Aimhigher and the education maintenance allowance, but we also know that we need the money. We have seen some staggering—multi-million—amounts of money being spent on our universities. It was inconceivable in my days of the '60s that such multi-million amounts would follow, but they have—the Government have delivered them.
	How has this year of recession affected Sunderland's funding allocation? We want more students and we want their talents to be developed so that they can join our economy. Sunderland's financial allocation for 2009-10 has increased by some 6.2 per cent., which is well above the national average. Teesside's allocation has increased by 10.2 per cent., which is more than double the national average. We must help areas such as mine where people have seriously low incomes and feel that they have a bigger hill to climb, and where traditional industries are changing. We need them on board.
	I am sorry that the hon. Member for Havant (Mr. Willetts) has left, because I hoped that he might respond to what was said in an article that appeared in  The Guardian. He would not allow me to intervene—I understand that, because we all have much that we want to say—but his views are made clear in the article, which states:
	"Universities are badly failing students with unfit teaching and old-fashioned methods and will have to radically modernise lectures and facilities if they want to raise fees, according to the Conservatives' spokesman on higher education."
	I want to know names. Which universities are using "old-fashioned methods"? Which universities are "failing students"? We need to know what is being spoken about here.
	The hon. Gentleman believes that
	"vice-chancellors are not prepared"
	to face the problem that he would be given by students "if fees go up". My husband has worked in universities throughout his working life, and I have been part of them in an indirect way. I can tell the hon. Gentleman that parents and students are in absolute agony in their wish to experience quality. They choose to go to the places where they believe that pharmacology, or engineering, is taught best. They judge on the basis of delivery and quality. When money is spoken of in this way, we should look at the qualifications involved.
	I wanted to challenge the hon. Gentleman on another issue, because I think it important for us to challenge each other in debates such as this. Universities UK makes the position very clear. It says:
	"Every survey shows satisfaction levels of 80 per cent. or above. These do not indicate deep-seated problems."
	It also says that there is a genuine belief that UK degrees are world-beaters—world-class—and I can say on the basis of my own knowledge that that is absolutely true. If the lead Conservative spokesman says that some universities are failing, it is important for us to know who he is talking about.
	The details of the student loan facility were articulated carefully from the Dispatch Box. It is clear that there are problems, but I was delighted to hear my hon. Friend the Minister explain how they would be corrected. I went to university in 1967, and most of my friends were waiting until November for their grants to come through. The present position is not new—and I was one of 5 per cent., not 39 per cent. Let us get things into perspective, and then the argument may become rather more rounded. The visa system is crucial, and we must not allow it to be bunged up in any way. The students in our universities are very important people.
	I am sorry to end on a down, but I think it important to say this. When the Government decided on the additional student numbers, they said that they would be tied to strategically important and vulnerable subject areas. I can tell the Minister that that was an arbitrary definition of requirement. I think that we should be much more cautious about using arbitrary definitions as though they were fact, and related to the requirements of our economy.
	The system was bureaucratic, and many universities in my area felt that emerging from that bureaucracy was an impossible task, but the extra 10,000 places are valuable. It is important for us always to acknowledge what a superb system of universities and higher education we have. Do not let us spoil it with systems that have resulted in serious problems for universities to handle, instead of the serious opportunities which I believe were intended.

Robert Wilson: May I begin by congratulating my hon. Friend the Member for Norwich, North (Chloe Smith) on delivering such an excellent maiden speech? She can be very proud of herself, and I am certain her predecessor would have looked on and nodded in approval. I am sure she will be his equal in every respect in fighting for the interests of her constituents in this House.
	In the short time available to me, I would like to focus on three areas: widening participation, the financial pressure on universities, and the student loan book. I know that other Members will more than adequately cover the issues to do with student numbers and the recent student loans payment crisis so I do not intend to cover those topics. Indeed, my hon. Friend the Member for Havant (Mr. Willetts) demolished the Government handling of the loans crisis in such a forensic manner that no more needs to be said on the subject.
	All Members probably accept that higher education will play a vital role if we are to emerge from this deep recession more able to compete in what is a highly skilled global economy. Enabling our young people to have the opportunity to gain entry into higher education is both morally right and an economic necessity. By preventing a large number of students from fulfilling their educational potential, the Government risk making the country less competitive. When we look at what has happened over the lifetime of this Government, we see that in higher education as elsewhere it is the disadvantaged groups in our society who have been failed most. While many more middle-class children have been able to go to university, those from lower socio-economic groups have struggled to make progress. Data from the Office for National Statistics confirm that in the most deprived 10 per cent. of neighbourhoods only three in 10 children go on to higher education, compared with six out of 10 school leavers in the least deprived 10 per cent. of areas. Moreover, this year tens of thousands of young people have suffered because the Government put a brick wall where a ladder should be, blocking the path to university for many who have worked so hard to get their A-levels.
	It cannot be denied that much of the answer for the underperformance of the lower socio-economic groups lies within our schools. As Ofsted has made clear, a whole swathe of our schools are underperforming and failing children. It is not just Ofsted that is making that clear, because only yesterday our captains of industry made clear their concerns. The chief executive of Tesco, the nation's largest private employer, described standards in schools as "woefully low". He said the private sector is now being left to "pick up the pieces" by having to spend resources on basics such as writing, numeracy and communication skills. The chief executive officer of Asda weighed in behind him, as has the CBI. The Department's response to this critique said it all: according to its spokesman,
	"standards have never been higher in our secondary schools."
	That brings to mind something that I think Tony Blair once said: if we do not understand the problem, it is very difficult to be part of the solution.
	Improving standards in schools is crucial, but we must also look at other ways to open up higher education to all groups. It is clear that the one-size-fits-all approach is failing. I have been extremely impressed by the US model of community colleges. I have spoken about it before in this Chamber, and I have been banging the drum for it for some time. I was therefore very pleased to see positive mentions of the community college system in the recent Select Committee report. Such colleges constitute the largest part of the higher education system in the US, offering short vocational courses as well as the equivalent to our foundation degrees. They provide access to learning for millions of students who otherwise would be excluded from a traditional university education.
	One of the main successes of the community college system is that many people from lower socio-economic and minority groups have thereby had an opportunity to engage in higher learning. Currently, 34 per cent. of students enrolled at community colleges are from minority ethnic groups. Students are also typically older, with 16 per cent. over the age of 40, and they are typically employed, too—77 per cent. are in full or part-time employment. Students typically begin the first part of their associate degree at a community college with the option of using accumulated credit to transfer to a traditional university to complete a bachelor's degree.
	By breaking down courses into bite-sized chunks, US colleges also offer the chance to reskill without having to shoehorn busy lives into rigid timetables. Credit is therefore a vital component underlying the structure and system. Americans rightly view the career ladder as a career lattice, where people drop in on education as and when it is needed and it fits in with their lives—in this country, we often see that as "dropping out".
	Important lessons can also be learned from how the US community colleges manage their finances; put simply, the model is much more cost-effective than the one in this country. Networks are organised on a sub-regional basis and groups of colleges often pool resources, such as human resources, and other administrative functions. As purely teaching institutions, colleges typically do not host very expensive research facilities, thus keeping financial pressures to a minimum. Although there are growing examples of good practice in the UK, such as the Staffordshire University Regional Federation consortium, which I visited, local articulation agreements should be encouraged. They should be led by a strong university at the core of each grouping. The UK has 172,000 students studying higher education in 269 further education colleges. Such colleges provide 39 per cent. of all entrants to higher education, so we already have a good base on which to build a US-style system.
	It is also clear that the student demographic is changing, and it is time that the Government realised that the higher education system can no longer be centred solely on the needs of 18-year-olds undertaking the traditional three-year course. Although spending on widening participation has increased, it has been sprayed around like a water cannon, whereas it should have been precision-guided. If the Government are truly serious about widening participation, they need to ensure a much more strategic focusing of funds.

Robert Wilson: I do not think that I have time to do so, because others wish to speak.
	I wish to move on to discuss the financial challenges faced by universities. They are cutting their budgets at an alarming rate and many are in considerable financial difficulty. As I said at the previous departmental questions in July, seven universities were on the Higher Education Funding Council's warning list of "at higher risk" institutions but soon as many as 30 could be on it, facing significant financial difficulties. Those not in any danger, such as my own university of Reading, are still having to chop huge swathes from their budgets. Financial pressures on the university of Reading have meant that it is cutting £10 million from its budget and has had to make painful decisions about closing departments, such as those of physics and health and social care, and courses in continuing education. The university recently announced that it has had to cancel its £60,000 joint sponsorship with Thames Valley police of four community support officers on its campus. I have had lengthy discussions with the pro-vice-chancellor about this, as both the safety of students and peace and quiet for local residents are priorities for me as the local MP. I am very concerned about that and have made my views clear, and I am continuing discussions with the university and the police about how we can ensure student safety will not be compromised. Many universities up and down the country are having to make even more painful decisions affecting staffing and the services to students than the university of Reading is.
	Finally, in light of this week's announcement, I wish to say a few words about the sale of the student loan book. In my previous position as shadow Minister for higher education, I was involved in this legislation, and it appears many of the concerns I raised at the time, along with my hon. Friend the Member for South Holland and The Deepings (Mr. Hayes), are being borne out by events. Throughout its passage, the Sale of Student Loans Bill was always deemed to be enabling legislation, necessary for a rainy day. Indeed, following its Royal Assent, the then higher education Minister withdraw the book from sale because he was worried about securing a fair price and was finding doing so increasingly impossible. Not much has changed since then regarding the value of the loan book in the marketplace, but the Government's need to get their hands on the money clearly has. The rainy day has arrived and it seems to have become a bit of a monsoon. The student loan book is once more up for grabs as part of a fresh sale of state assets that aims to raise an estimated £16 billion.
	The Prime Minister announced that the sale would not go ahead if a good deal could not be brokered, but I feel that the panic to plug this massive financial black hole will override the financial caution. I want to repeat what I said during the passage of that Bill—the legislation was supposed to be about the sensible management of an important public asset, which at the time was worth nearly £20 billion, but it has actually become a tawdry attempt to cash in on a valuable asset by a Government running out of resources and of money. The former higher education Minister, the hon. Member for Harlow (Bill Rammell), said on Second Reading:
	"Making a sound judgment about the timing and pricing of sales is particularly important given the recent turbulence in world credit and financial markets...Decisions will...always be informed by what provides the best value for money for the taxpayer."—[ Official Report, 22 November 2007; Vol. 467, c. 1393.]
	Indeed, if my memory is correct, at our insistence a framework for making the decision was put in place in the Bill, but I do not think that details of that framework were ever published. The Minister for Higher Education and Intellectual Property cannot sidestep that issue, as he tried to earlier when he was pressed by my hon. Friend the Member for South Holland and The Deepings. The details of that framework should be published so that we can all see just what the criteria are to which the Government are working. If they are not published, people will believe what I believed when the Bill was introduced: that the Government are in danger of stripping taxpayers of a valuable public asset in the hope of receiving a quick cash injection. The Minister must surely be aware that flogging assets recklessly will not make the Exchequer solvent.
	What about the students? The former higher education Minister repeatedly stated during the progress of the Bill that it would have "no material impact on graduates". That proposition remains entirely dependent on the good will of the Government. Given their incompetence with all things student related—particularly this summer—that is a precarious safeguard. This car boot sale of state assets needs to be managed with caution. The quick sale of the student loan book is no substitute for a long-term plan to get the economy back on track. Any business man—like me—can assure the Government that a short-term sale for a quick fix is definitely not the way forward. The structural budget deficit is what must be targeted.
	We are very fortunate that we have a world-class higher education system in this country. However, through their focus on short-termism and their mismanagement of the UK economy, the Government have made many universities vulnerable to financial problems and international competition. As events over the summer have proved, the Government have lost their grip on higher education. I fear that the only way to get it back on track is a general election and a fresh approach from an incoming Conservative Government.

Anne Main: I want to touch briefly on one or two points raised by my hon. Friend the Member for Reading, East (Mr. Wilson). He said that there is no point trying to widen participation in education when so many of our children are leaving school failed by this Government's system and with poor qualifications. Indeed, other hon. Members have also touched on the fact that many colleges have, like Oaklands college in my constituency, had the learning and skills grant pulled at short notice. That college is attended by many severely disabled pupils because Hertfordshire keeps its disabled pupil teaching within Hertfordshire and the college specialises in such teaching. It was hoping to widen participation for those disadvantaged young people, and what happened? At the eleventh hour and the 59th minute, the funding was pulled, leaving my college in a dilemma about what to do next. It is still struggling with that dilemma and Mark Dawe, who I meet regularly, has my utmost sympathy. It is no good seeing crocodile tears from the Government.
	I want to touch briefly on a topic that has not come up. Many young people have been let down because they wanted to go to university this year but have been caught up in the regrading fiascos that, unfortunately, left them unable to take up their university places. Dr. Jack Alvarez, my constituent, who teaches at Haberdashers' Aske's school, which is just outside my constituency, wanted me to bring the matter to the attention of the Minister. Many extra pupils have been participating in GCSEs and, importantly, A-levels and AS-levels, and if the grades are challenged, the challenges need to be lodged within a certain time frame to ensure that they meet the clearing house dates.
	Priority requests for regrading are usually handled within 18 days. Awarding bodies have until 7 September to deal with them, but the universities close their books by 28 September, and the bulge in the numbers of pupils applying to go to university this year has led to the matter being especially badly handled.
	This year, 80 per cent. of all clearing places were taken by 25 August, even though exam results were released only on 20 August. Although the good news was that many high-flying pupils did get their results upgraded, I am sad to relate that the short time frame meant that a lot of them missed the opportunity to go to university or to the university of their choice, or they lost their university place.
	The Minister must look at the problem. It is pointless to encourage young people to go to university if regrading is shoehorned into a time scale that is, frankly undeliverable. The result is that high-flying, well educated and qualified pupils from all walks of life end up being unable to access a college place of their choice. Some of them have looked at the loans fiasco, realised that it would cause them to struggle financially and said, "I'm walking away."
	If the Government want to deter young people from participating in higher education, all they have to do is to put them in a system where there is very little chance of fair play. As happened with the loans fiasco, people who tried to communicate the problems that they were encountering found that the phone lines were impossible to access.
	I shall rest on that point. We should think about what young people face: it is hard enough to start out in life but, when more than one obstacle is put in our way, many of us would say, "Forget it." Given the stresses and strains that hon. Members have suffered over the summer in our relationship with bureaucracy, surely we must recognise that many people will walk away when faced with the sort of obstacle that I have described.
	If we want to encourage young people into higher education, we must ensure that they leave secondary school with the qualifications that they need, and then that their places and loans are managed properly.

John Hayes: We have had a rigorous and well informed debate, in which we heard an excellent maiden speech from my new hon. Friend the Member for Norwich, North (Chloe Smith). She is a bright star with a bright future.
	This Government promised to extend opportunity and to ensure that 50 per cent. of young people attended university. That promise was made by the former Prime Minister Mr. Blair in a speech 10 years ago, and it was repeated in the 2001 Labour party manifesto, yet today's debate has been all about broken promises and false claims. The scar of disappointment cuts deep—in some cases to despair.
	Even though the figures have been recalibrated and recalculated, by last year the Government had achieved just 43 per cent. participation in higher education. Success for women masked failure for men, for whom the rate stood at 38 per cent.—just one percentage point higher than a decade ago. Under a consistent measure, the proportion of university entrants from both sexes increased hardly at all over the whole decade.
	Both my hon. Friends the Members for St. Albans (Anne Main) and for Reading, East (Mr. Wilson) made good contributions to the debate. The latter has championed the cause of community colleges for some time. I acknowledge and praise him for that. His remarks were interesting and stimulating, on a matter that we certainly take seriously even if Ministers do not. However, I am sorry to tell my hon. Friends that, even though the Government are spending £2 billion a year on widening participation, the participation rate for working-class students has hardly improved since 1995.
	If that were not bad enough, the improvement rate has actually declined. In the previous decade, participation by working-class students grew at a faster rate. Although I acknowledge the genuine determination across the House to try to widen participation, the truth is that the Government have failed by any measure. It is clear that there are Labour Members, such as the hon. Member for North-East Derbyshire (Natascha Engel), who care about these matters. It was especially distressing to hear how her ambitions, and the ambitions of the whole country, have been frustrated down by Ministers—not through lack of concern, but through their inability to deliver results.
	The experience at the beginning of the current academic year has demonstrated beyond all doubt that the Government have no hope—and, worse, no intention—of meeting their 50 per cent. target.
	Even though applications increased by a predictable measure this year, the result, as my hon. Friend the Member for Havant (Mr. Willetts) noted in his excellent opening remarks, has been chaos. While the Government blew up expectations, parents and students have been let down, the dream of a generation has been exploded, with universities left to pick up the pieces. There are 140,000 potential students who cannot find a place in higher education, as my hon. Friend the Member for Havant pointed out and only 22,000 places were available through clearing; that is down by 50 per cent. from the year before.
	That so many young people should lose their chance to learn can hardly come as a surprise to Ministers. Universities received roughly 60,000 additional applications this year. The Minister for Higher Education and Intellectual Property broadly confirmed that, yet the Government simply did not allocate sufficient places to meet that extra demand. Every previous recession has brought an increase in the number of applications for university places, so the Government must have known that that would happen. The issue should have been anticipated and dealt with, and a solution should have been found.
	The Government are still nowhere near their target, and yet the system of student finance that they established has not been able to cope with the pressure, as was generously acknowledged by the hon. Member for Stockton, South (Ms Taylor). She said that the situation was not good enough, and challenged those in her own party, on the Treasury Bench, to recognise the problem. I must be fair to the Minister of State: he did acknowledge it. His words were damning of his own record and that of his hon. Friends. He said that the situation was not good enough; that it was not effective; that it had not been sensibly anticipated; that the technology had failed; and that systems had let students down. But who is to blame? I am afraid that the buck stops on the Government Front Bench. The Minister knows that, and should have acknowledged that, too. After all, it is the Government who shifted responsibility for processing loans from local authorities to Student Finance England.
	Announcing the new system in 2006, the then Education Minister, the hon. Member for Harlow (Bill Rammell), said:
	"As well as clearer information, faster decisions, timely payments and accurate repayments"
	would be assured. It is no wonder that after doing so little for HE, and FA for FE, he was sent to the FO. He left a legacy for the Minister for Higher Education and Intellectual Property; I know that the situation was not of the latter's making, but it is still his responsibility. How stark is the contrast between past soft-soap rhetoric and the granite-hard reality of the problems facing students and their families this year!
	Some 175 students started this term without loans. Worst hit are first-year students, as the hon. Member for Bristol, West (Stephen Williams) said. At the end of last week, 28 per cent. of first-year applications had yet to be dealt with, and universities are being obliged to make emergency pay-outs. I hope that when the Minister for Further Education, Skills, Apprenticeships and Consumer Affairs winds up, he will talk about those emergency pay-outs and will comment on the questions asked by the hon. Member for Bristol, West, about how easy those pay-outs are to access, and what the Government are doing to support universities in that regard.
	The problems could have been anticipated. Indeed, they were; minutes from the board meetings of the Student Loans Company reveal that in July 2008—a full year before the problems became public—the company forecast that 40 per cent. of telephone calls would go unanswered. At the same meeting, a policy of avoidable contact was adopted. That, by the way, is Labour-speak for not answering the phone. The Student Loans Company is using an 0845 number, against official Ofcom advice, so callers must pay for a 10p-a-minute call, and some of the revenue can be "shared" with the Student Loans Company. I call that adding insult to injury, and adding impertinence to both.
	To add to the chaos, the future of the student loan book is now unclear. At the beginning of the week, the Government announced a fire sale of Government-owned assets. Back in 2007, the comprehensive spending review committed the Government to raising £6 billion over the next three years from student loan sales, yet no sale has yet been made. When the Minister winds up the debate, will he tell us whether the £3 billion is in addition to the £6 billion in the CSR? Can he tell us when he expects the first tranche of loan sales to be made, and if no sale is expected to be made by the end of the financial year, can he say how the Government intend to make up the £6 billion shortfall?
	In the past year, there has been a succession of crises in HE, further education and skills. First, there was the crisis over FE capital funding; then the crisis of the Train to Gain overspend and the problems with apprenticeships; and now there is the crisis in student finance. Is it any wonder, when responsibility for this vital area of policy has been shifted from one Department to the next, like a macabre game of pass the parcel—first DFES, then DIUS and now BIS? But this is not a game. The Government are playing with people's lives—the hopes, dreams and potential of a generation. In Labour's end, to paraphrase Eliot, is its beginning—a 13-year journey back to where it started.
	As the Minister for Higher Education and Intellectual Property knows, I admire his progress from disadvantage in Tottenham to high office. I know that in his heart he must be ashamed that as a result of his Government, few others so disadvantaged will follow in his footsteps. For he must also know in his heart that if we want to reinvigorate higher education, if we want to reignite social mobility, if we want to deliver social justice, we need a Government who genuinely believe in education: change driving hope, a fresh start—a new Conservative Government for a new Britain, because Britain deserves better.

Kevin Brennan: We have had a good debate with some excellent contributions, some colourful ones and some thoughtful ones from both sides of the House. It has been an immensely enjoyable debate.
	I congratulate the hon. Member for Norwich, North (Chloe Smith) on her maiden speech. She spoke with great clarity and passion about her constituency. I particularly thank her for the praise that she gave to her predecessor, Dr. Ian Gibson, who is a close friend of mine and was an excellent Member of the House. She said that she wanted to emulate his independence in the House. I hope she has informed her Whips Office of that, as I am not sure her Whips will so heartily praise her if she does so.
	We are clear that finance should not be a barrier to people entering university. The hon. Member for South Holland and The Deepings (Mr. Hayes) referred to the background of my right hon. Friend the Minister for Higher Education and Intellectual Property. Both my parents left school at 14, and I come from the first generation of people who had the opportunity to go to university, coming through comprehensive education and going to Oxbridge. If people have been through that experience, it stays with them and makes them genuinely and honestly committed to widening participation and access.
	That is what the Government have done. Many more people from my kind of background are now able to go to university than was the case in past, and certainly when I went to university in the early 1980s. We are committed to widening access to higher education, and that is what we have been doing. That is why we have a generous system of student support providing both grants and loans for tuition fees and living costs in university. That is why we have non-repayable maintenance grants of up to £2,906, which were reintroduced by the Government. About two thirds of all students are expected to benefit from a full or partial maintenance grant.
	Whatever review takes place— [Interruption.] I hear the hon. Member for Bristol, West (Stephen Williams) chuntering—it will not involve the savage cuts that the Liberal Democrat party leader seems to have promised, although the hon. Gentleman was quick to distance himself from that. However, it is appropriate to refer, as my right hon. Friend the Minister did, to the problems that there have been with the Student Loans Company. He gave a clear explanation of events. It is a matter of great regret that students have not been able to get through to the Student Loans Company to speak to an adviser and find out about their application. Students and parents have been confused about the process and about what has been happening with their applications. The poor level of customer service, as my right hon. Friend made clear, is not good enough.

John Leech: rose—

Kevin Brennan: I have very little time, so if the hon. Gentleman will allow me to make some progress, I may give way later.
	The Student Loans Company has put measures in place with financial support from the Government to help students follow the progress of their applications and to address the problems that people have had in getting through to its call centres, including providing additional helplines and more staff to answer calls. Action is being taken, but we should keep the problems in perspective.
	Every single one of those applications is important, but more than 640,000 students have been paid by Student Finance England this year. That is more people than ever before at this time of the year, and we should acknowledge that a significant number of students do not apply until shortly before the start of term. The suggestion of 175,000 students still being unpaid is way off the mark. Each year a large number of students begin applications but do not complete them. I understand from the Student Loans Company that this year that amounts to 77,000.
	My right hon. Friend announced a review under Professor Deian Hopkin, which has been welcomed. In response to the point from the hon. Member for Bristol, West, the review will be undertaken as quickly as possible. We should make a judgment on what has happened when we hear the full conclusions of that independent review, but it should not divert us from the fact that this year more students than ever before are going to university. From reading the motion and listening to the hon. Member for Havant (Mr. Willetts), one would think that fewer students than ever before were going to university. The Opposition's motion regrets the rise in the number of applicants without a place, and we need to unpick that, because it means that the Opposition are saying that we should have provided more places. I heard the hon. Gentleman say that, but let us just analyse it for a moment. When we had fewer students a few years ago, the Opposition said that we had too many—that we were shovelling people into university; now that we have more students than we had then, the Opposition say that we have too few. How on earth can anyone sustain that position?
	The hon. Gentleman has been described many times as having two brains, and perhaps that explains how two totally different positions can be maintained within the same head. That is the only possible explanation, because it would cause most of us great mental perturbance if we tried to square that circle.

Kevin Brennan: I am not sure of the answer to that question, but I suspect that the money would not come from somebody who saved in a credit union; it would be more likely to come from somebody with access to a hedge fund, rather than anybody from the communities that we are discussing.
	To talk about widening participation while proposing a highly regressive policy on higher education, combined with a completely bogus way of paying for additional places, really is disingenuous. We look forward to seeing the detailed costings of this fag-packet policy. I do not know whether the hon. Gentleman was consulted when the Leader of the Opposition talked about it on a Sunday television programme, nor whether the shadow Chancellor was consulted, but it is unravelling just as quickly as the right hon. Gentleman's pension plans.
	When will the man with two brains tell us whether there is one single coherent strand to his policy for extra places? It is not extra cash: one cannot magic money out of nowhere. Even in opposition one has a duty to be responsible about finances, and we look forward to hearing him tell us exactly how he would pay for that policy.
	I fear that my time is running out—[Hon. Members: "Hear, hear!"] I am afraid that it is running out as rapidly as the credibility of the hon. Gentleman's policy. We shall oppose the motion and I urge the House to support the Government's amendment.
	 Question put (Standing Order No. 31(2)), That the original words stand part of the Question.
	 The House proceeded to a Division.

Andrew Lansley: I beg to move,
	That this House supports maximising public access to NHS dentistry; notes that under the Government's new contract considerable numbers of patients now do not have access to an NHS dentist; believes the dental contract imposed by the Government is not adequately meeting its objectives for improving oral health or access to dentistry; recognises that any future contractual arrangements should be appropriately consulted on and piloted; calls for stronger incentives for dentists to carry out preventative care; recognises the opportunity to bring about better patient care by ensuring the best treatments are provided at the appropriate time and by fostering the stability that will allow new investment in NHS practices; supports an approach to NHS dentistry focused on preventative care; further believes that the oral health of children should be protected by re-introducing dental screening programmes in schools; and further supports the introduction of patient registration, allied to capitation-based funding rather than fee-for-service, restoring a relationship between patient and dentist conducive to an improvement in long-term oral health.
	The House may not know it, but this is a 10th anniversary debate. Ten years ago, in September 1999, Tony Blair told the Labour party conference:
	"Everyone will have access to an NHS dentist within two years."
	The Labour party conference a couple of weeks ago might have done well to remember that the nature of promises from Labour Governments is that they are not delivered. In fact, the record shows a loss of access. After the introduction of the new contract, the number of people accessing NHS dentistry fell by 1 million. Some 7.5 million people are not going to an NHS dentist, because it is hard to find one. Fewer children are accessing NHS dentistry—more than 100,000 fewer than before the new dental contract. Dental caries is now the third most common reason for children's admission to hospital.
	What is the public's view of the state of NHS dentistry? The British social attitudes survey shows that only 42 per cent. of the public are satisfied with NHS dentistry, compared with a 76 per cent. satisfaction rate with the general practitioner service—although the Government constantly claim that we should be dissatisfied with that service. No doubt the Minister will attempt to pretend that the public are satisfied with NHS dentistry, but they are not.
	Promise after promise on NHS dentistry has not been kept. After every failure, the Government make a new set of promises that, in their heart of hearts, they know they will not be around to keep. Their latest promise is to deliver access for everyone who seeks it by March 2011 at the latest. There is no evidence of how they intend to achieve that.
	The Government knew that NHS dentistry needed change, and in preparation for the new dental contract, they rightly piloted new schemes. The personal dental services contracts were designed around the proposition that instead of the dentist treadmill—under which dentists were paid fees for services—dentists would be paid on a capitated basis for the number of patients registered. The idea was to incentivise dentists for encouraging good oral health, rather than simply for activity. But what happened? The PDS contracts were examined by the Audit Commission, which concluded that patient charge income had fallen by 30 per cent. as a consequence of the pilots, because there were fewer treatments. The Government should have said, "Well, that's worked then. We wanted to incentivise not just treatment, but good oral health, and a consequence of that will be a reduction in the number of treatments that are chargeable to patients." But no, completely the opposite happened. They said, "Well, we can't have that. We can't have the economic viability of the NHS dental service being undermined by the fact that patients aren't paying enough," so they scrapped the PDS pilots and imposed a new contract on the dental profession that had not been piloted. Contrary to the dental profession's expectation that it would be able to get off the dental treadmill, it remained on it, only with the primary care trusts, instead of it, in charge of the speed of the treadmill. We have ended up, therefore, with a continuing activity-based contract, and one that, owing to the way in which it was imposed and the nature of the contractual provisions, actually led to a substantial reduction in the number of dentists willing to sign up to the contract.

Stephen Hesford: The reverse is true in my constituency, where three new dental practices have opened in the past year—I had the honour of opening all three. The hon. Gentleman's experience of the new contract is considerably different from mine.

Andrew Lansley: The hon. Gentleman must explain why nationally the number of dentists choosing to enter a direct contractual relationship with their PCT has fallen by 7 per cent. in the past year—it involves only 31.8 per cent. of dentists. I freely acknowledge that there are more dentists in this country than ever before, but that is not the point. The point is this: how many dentists are willing to be NHS dentists? And how many of those who are NHS dentists find that the access provided to their patients in the locality is not as good as it used to be?

Stephen Hesford: rose—

Andrew Lansley: I will not give way. I tell the hon. Gentleman, and other Labour Members, that the Health Committee produced a report last year into dentistry. The report said that there were four criteria—not its criteria, but the Government's—for the new contract, namely access, clinical quality, NHS commissioning and improving dentists' working lives. I remind Labour Members what the Select Committee report said about those four criteria. On access, it stated:
	"The Department's original goal that patient access to dental services would improve from April 2006 has not been realised."
	On clinical quality, it stated:
	"While the Department argued that the new contract would improve preventive care, this was disputed by dentists who claimed that the new contract failed to provide the time and the financial incentive to do so."
	On commissioning, it stated:
	"The Minister admitted that PCT commissioning of dental services has been poor."
	On improving dentists' working lives, it stated:
	"The new remuneration system based on UDAs"—
	units of dental activity—
	"has proved extremely unpopular with dentists."
	Does the hon. Gentleman want to respond?

Andrew Lansley: I do not know what point the hon. Gentleman is trying to make. I have new NHS dental practices in my constituency. The Minister might even have a note about them to use later in the debate. That is not the point. The point is this: what is the overall picture? That picture is very clear. The number of people accessing NHS dentistry after the introduction of the new contract in April 2006 fell by 1 million. It has now recovered by about 500,000. That is across the country. I do not think that those figures are disputed. The point is that even now—three and a half years after the contract was introduced—access to NHS dentistry is poorer than when that access was one of the central criteria.
	Many people think that they have access to an NHS dentist—I suspect that many in the House think that they have such access. However, if they went to their NHS dentist, especially if they did so in the first quarter of the calendar year—the last quarter of a financial year—they would find dentists who have reached their UDA limit and that their dentist is not their dentist at all, because registration has gone away. We do not have "our" NHS dentist; we have access to NHS dentistry on sufferance of the local primary care trust.

Norman Lamb: rose—

Andrew Lansley: I do not disagree with that, and my hon. Friend the Member for Hemel Hempstead will certainly want to elaborate on that point when he replies to the debate later.
	The Steele report identified that the current contract was based on activity and was therefore misguided, and that we needed to move to a contract based on prioritising and incentivising good oral health and preventive care. However, there is no plan to move from A to B. We have consistently made it clear that it is our objective to make that move to a contract based on registration and capitation that incentivises quality and outcomes rather than simply focusing on activity. I want to say a few words on how we propose to do that.
	There are two parts to our proposal. First, we propose to take immediate steps to ameliorate the problems in the existing contract. Secondly, we propose a more fundamental phase of reform. The immediate steps, under the current structure of units of dental activity, would enable preventive care to be incentivised. We know that every £1 spent on giving a patient preventive dental treatment can save at least £8 in subsequent curative work. We need to support children with information and advice on how to look after their teeth. I have read the Department's toolkit to support that activity, but we need to make it more systematically available. That is why we will restore school dental checks for every child, which have been surreptitiously phased out by primary care trusts since 2007. We will also enable children to continue to access NHS services through child-only contracts.

Andrew Lansley: The hon. Gentleman and the Government need to recognise this point. In their amendment to our motion, the Government claim that children's oral health in England is already among the best in the world. The evidence for that is the 2003 child dental health survey. We have not had such a survey since 2003, however, and we will not have one until 2013. We know, however, that children are presenting at hospital with dental caries, and that that is the third most common reason why children are admitted to hospital. In 2001-02, just before the last child dental health survey, that did not feature among the five most frequently reported diagnoses when children presented. We also know that children are not accessing NHS dentistry to the extent that they did. Significant numbers of children are therefore not seeing a dentist, and we need to ensure that that changes. It is perfectly obvious from looking at the Department's toolkit to support better oral health among children that there needs to be a focus to bring about that change. School dental checks, if they are integrated into the local commissioning of dental services, could do that.
	The third thing that we need to do rapidly is to give people more access to NHS dentistry. That is not just about insisting that the PCTs issue more UDAs, or about simply piling money into the system—valuable though that might be. The issue is about winning more capacity from within existing resources. For example, there are unnecessary recalls, including cases of people finding their treatment being divided between a first attendance and a subsequent one more than three months later. The chief dental officer himself rightly criticised that practice, identifying it as a result of one of the perverse incentives in the current contract. Without such practices, we could be looking at a potential capacity for 2.3 million people to access NHS dentistry. We are not even assuming half that figure in our plan to give 1 million more people access to NHS dentistry by eliminating such unnecessary recalls.
	We also need to get more out of dentists' working hours. We are therefore going to return to dentists the power to charge patients who repeatedly miss appointments. Five per cent. do so on a regular basis, and 1.8 million courses of treatment are wasted. If only a quarter of that waste were remove by this measure, it would enable 100,000 more patients to be treated.

Andrew Lansley: No, I do not. Dentists already have a mechanism for charging patients. Since the late 1940s, there has been a clear expectation that the system of co-payment applies to NHS dentistry, but not to other NHS services—and I have no intention of changing that.
	We need additional fundamental reforms so that we can move to a new registration-based contract with payments linked to the good oral health of patients through a capitation system properly adjusted for the patients being looked after—I recognise the Liberal Democrat point about the need to incentivise dentists in areas where oral health is poorest—while also providing a proper incentive for preventive care, as my hon. Friend the Member for Westbury (Dr. Murrison) has mentioned.
	We also need to bring more dental professionals back to the NHS, which is why we have proposed—I am glad to say that the Liberal Democrats recently supported us—that NHS or state-trained dentists, who cost about £170,000 each, should be required to work in the NHS for at least five years. We need generally smarter commissioning where we open it up, so that people can access preventive work. I am particularly pleased to confirm today that we will widen access to preventive advice and treatment by removing the regulation that prevents a dental hygienist from seeing a patient if the patient is not directly referred by a dentist. We are seeking to empower the whole dental team to work together to deliver innovative and preventive advice strategies.
	The Government, far from listening to the Steele review and moving in that direction, unfortunately appear to be moving in the wrong direction. At the time the Government received the Steele report earlier in the summer, they had started work on implementing not that review, but their own draft access contract—contrary to what is expressed in their amendment to our motion about meaningful consultation and
	"working with the dentistry profession and other stakeholders".
	This is yet another example of an activity-based contract focused on a narrow objective rather than on good oral health as a whole, which will not support preventive care as it should. It has so failed to engage the profession that the British Dental Association has advised its members not to sign the new contract.
	I am not often minded to read with much care the amendments that Ministers table in response to our motions in Opposition debates, as they tend to be far too self-congratulatory. This particular amendment, however, seems to make a whole series of claims that are simply not justified—they are plain wrong. The Government are not working "through careful piloting" on either the current dental contract or their new proposed draft access contract. They are not working together with clinicians as they should. They claim that
	"children's oral health in England is... among the best in the world",
	but the evidence of recent years since the last child dental health survey points to a significant loss of access and dental problems among children. They talk about
	"access for all... by March 2011",
	but that is risible in the light of their utter failure to deliver improved access over the past decade.
	The Government told everyone that they would offer access to NHS dentistry, but they failed. They talked about prevention, but they incentivised only treatment. The dental treadmill is just rolling forward in exactly the same way as it always did. No doubt money has been poured into the system. The Minister will doubtless talk about the level of inputs in dentistry, but the issue is not about inputs but outcomes. Once again, it is a familiar story from this Government: it is all about how much money has been spent and never about the proper structure of reform or the outcomes being achieved. The Government are pursuing that flawed approach all over again. Once more, we need a new approach to access and quality that is based on outcomes and results and not simply on processes. We need proper incentives for prevention and for delivering good oral health, working with professionals rather than against them. By those mechanisms, we will reverse the long and slow death of NHS dentistry.

Mike O'Brien: I beg to move an amendment, to leave out from "NHS dentistry" to the end of the Question and add:
	"welcomes Professor Steele's review report and its endorsement that the principle of local commissioning introduced by the 2006 reforms provides a firm basis on which to develop NHS dentistry; agrees with the vision set out in the review of improving incentives to support dentists in delivering access and quality; acknowledges the Government's commitment to working with the dentistry profession and other stakeholders to ensure through careful piloting that it implements the recommendations in a way that delivers the best possible system for patients, dentists and the NHS; acknowledges that children's oral health in England is already among the best in the world; welcomes the commitment of the NHS to deliver access for all who seek it by March 2011 at the latest, supported by some £2 billion in central funding for dentistry, and understands that access is now growing again; notes that in the last four quarters the number of people seeing an NHS dentist in the previous 24-month period has grown by 720,000; further notes that the dental workforce is growing, with 655 more dentists working in the NHS in 2007-08 and a further 528 in 2008-09; and recognises the support that the dental access programme of the Department of Health is providing to clinicians and managers to help them rapidly expand NHS dental services where necessary.".
	In 1997 we inherited an NHS that was on its knees and in a mess, and NHS dentistry was part of a system that was struggling. In 1991 two dentistry schools were closed by the Conservative Government. The number of dentists in the country was seriously down, and there were enormous problems.
	The hon. Member for South Cambridgeshire (Mr. Lansley) disparaged the idea of looking at the record of his own party in government, and I understand why he does not want to look back. All that I can say to those who may be watching this debate is that we do not need to listen to the rhetoric, because we can look at the book. We can look at the history. We can look at what the Conservatives did to the NHS last time. We can look at the way in which they left it—and we can know that, if they are re-elected, they will do exactly the same again. This Government, on the other hand, are committed to providing access to high-quality dental care for everyone who wants it, and we are committed to providing it through the national health service.
	Dental access has improved for the whole of the last year, with 720,000 more NHS patients seen by NHS dentists. The Steele review, which we set up, has been accepted and welcomed by the British Dental Association. We have increased spending, and yes, spending is important. The hon. Gentleman may not think that it is important, and he may well feel that his Government would be free to make the cuts in the NHS that they made on the last occasion, but we take the view that increased spending on dentistry is necessary. It was up by 11 per cent. in 2008-09, and it is up by 8.5 per cent. this year. This year funding is running at £2.25 billion net of patient charges. Since 2004 it has risen by 70 per cent.: that is £900 million more in six years. Let me say to any dentists who happen perchance to read the report of this debate that they will be able to look back and see what the Conservatives did last time, and to compare it with what this Government have done in terms of putting money into dentistry.

Andrew Murrison: Does the Minister not understand that dentists feel deeply demoralised? Nine years after the 1997 general election, the Government undertook wholesale reform of the system; just three years after that, they are winding the clock back to the previous position, and dentists are entitled to ask what on earth is going on. Such changes—welcome though they must be, because the Minister's system has clearly failed—must be seen as deeply demoralising to the dental profession, so perhaps the Minister would like to apologise.

Mike O'Brien: Let me just say the following about the way we have structured some of the charges and the funding. Previously, the funding levels and the charges patients paid were enormously complicated. We have simplified the whole process. We have a choice here. We can have multiple variations in the charging system so everything is charged at different rates for different sorts of systems. Frankly, that will create massive bureaucracy for dentists and massive complication for patients. Alternatively, we can simplify the system so that people can understand what they have to do. In that case, we have to rely on—let me make this very clear—the professionalism of the dentistry profession to ensure they are doing what is clinically necessary. We have taken the view that most dentists are in the job because they want to do the best for their patients—It is clearly a different view from that of the Conservative Front-Bench team but it is the view we take—and we have therefore decided that we need to have an appropriate system of charging and remuneration to take that into account.

Sandra Gidley: rose—

Sandra Gidley: Does the Minister accept that the system has been oversimplified, thus leading to cases such as that of a constituent of mine who was told she could choose which tooth to have repaired and would have to wait six months to have the next one done? Thankfully, that is being investigated. I would hope it is a rare case, but nevertheless some dentists do seem to be being forced down that path, as a direct result of an oversimplified system.

Mike O'Brien: I do not accept that dentists are being forced down that path. There will always be some in such professions who do not do what is clinically appropriate and do not use the system as it ought to be used—I put that at its mildest, perhaps. However, we believe it is important to recognise that the dentistry profession has responsibilities, standards and professional organisations that seek to regulate it. We need to ensure that we have a system that not only makes sure that we have a good quality of care—and we have to rely on professionalism for that—but that also has a charging structure that is not overly bureaucratic. It appears that some in the Opposition want to introduce such an overly bureaucratic charging system, however.
	In the years since the foundation of the NHS, dental health in our country has improved massively. I want to make it clear, however, that registration was not one of the reasons for that massive improvement. Registration payments were introduced only in 1990. There was continuity of care before that, and, broadly, there has been continuity of care in recent years. Therefore, before the hon. Member for South Cambridgeshire over-emphasises the importance of the registration issue, he had better check the historical facts. Registration is, in fact, just a payment system. Continuity of care is what matters. That is what Steele said; that is what he recommended we should ensure happens, and that is what we are seeking to put in place.
	Let us look back to see how NHS dentistry has changed things in this country. In 1948, half of all adults had no natural teeth at all. By 1968, the NHS had cut the proportion to 40 per cent., and 10 years ago it had fallen to 11 per cent. We are about to start the next national adult dental health survey and we expect this figure to have fallen still further to about 6 per cent.
	Let me give another example. Thirty-five years ago, more than 90 per cent. of all 12-year-olds in England had tooth decay. Today, that proportion is lower than 40 per cent. In fact—I do maintain this—our older children have some of the lowest rates of tooth decay in Europe, and they are comparable with the best in the world, including those of the United States. We can always do better, however.

Paul Beresford: rose—

Mike O'Brien: I will give way to the hon. Gentleman a little later, but if he will forgive me, I want to make some progress now as I am conscious that several Back Benchers want to contribute to the debate.
	The best decisions are those that are made as close to the patient as possible. In 2006, in line with the rest of the health service, we reformed NHS dentistry. The new system gave power to primary care trusts to commission the right dentistry services for their communities. PCTs have provided incentives to encourage prevention and improve quality, but in some areas progress has been too patchy and too slow. Therefore, in December 2008, the then Secretary of State for Health asked Professor Jimmy Steele to conduct a review of the new contract, which he published in June. I am delighted to say that the review joined the Select Committee on Health in strongly supporting the principle of local commissioning, providing a firm basis for the future of NHS dentistry.
	The review also showed the range of services that are needed. It showed that the different generations need different types of dental care and that, rather than simply drilling and filling, maintaining oral health and preventing decay and disease must increasingly be a priority. I did agree with some of the points raised by the hon. Member for South Cambridgeshire, and it appears that we are at one on ensuring that we prevent decay and treat maintaining oral health as a high priority. On the basis that I have set out, the Government wholeheartedly welcome Professor Steele's review. We will be rigorously testing its recommendations through pilots across the UK—there will certainly be pilots across England—over the coming months.
	I am pleased to say that the British Dental Association, patient groups and other stakeholders have welcomed the review. The Government have shared their implementation plans with the BDA and others, and they will be playing their part in delivering them. We have made a good start. Professor Steele recommended that we should develop measures for monitoring the quality of dental services, and we are developing a set of key performance indicators for all new contracts under the dental health programme. The work has already begun to develop clinical pathways and procedures to ensure that all new patients receive an assessment of their oral health and the treatment that they need.
	It is important that we ensure that oral health improves. The level of tooth decay among 12-year-olds in the UK is at its lowest ever and is among the best in European countries, although inequalities remain. We want every child to access dental services, but all the evidence shows that, contrary to what the hon. Gentleman suggests, mandatory school screening is not the way to achieve that. That is what the research considered by the National Screening Committee showed; children in deprived areas, who are most likely to be shown to need treatment, were found to be the least likely to be taken to a dental practice to receive the treatment that they need. In other words, the suggestion sounds good, but we need to examine this issue in a much more effective way.
	If we really want to deal with the issues associated with child tooth decay, we will find that the better way to do so is to ensure that we have fluoridated water supplies and that we make changes in the way in which dental health is examined to ensure that we target those in the most deprived areas for the additional help and support that they need. We are examining ways in which we can identify and put help into areas where there are the most problems.
	In addition, we have begun to look at the way to improve the information available to patients on NHS Choices so that, as Professor Steele recommended, patients have accurate and up-to-date information about what NHS dentistry entitles them to do and how they can best access it. We are working with the NHS Business Services Authority to improve the data that we collect from dentists, which was another of Professor Steele's recommendations. That will provide a better sense of the nature and quality of services that dentists are providing. I know that dentists did not like the 2006 contract that was introduced, but I hope that the way in which the review was conducted and the way in which its recommendations will be implemented will help to heal some of those wounds, because we want to work with the dental profession as we pilot and evaluate the changes. I promised to give way to the hon. Member for Mole Valley (Sir Paul Beresford), so I shall do so now.

Mike O'Brien: I will look at those results. We are prepared to look at the evidence and to make judgments based on it. It is important that when we get independent reports that suggest that spending £17 million on NHS dentists going into schools is not the best way of spending that money we consider the evidence and base our policy on it rather than on some historical view that that was a nice thing that might perhaps be popular. We need to base things on the evidence.

Bill Wiggin: I am particularly interested in what the Minister said about continuity of care. Will he take the opportunity to look at what is going on in Herefordshire? I decided to test the NHS for myself and waited in the queue. I eventually got to the front and had a filling, which fell out two weeks later. I still cannot see a dentist to get it put back in again. Unless people are in pain, it is almost impossible to see a dentist. I am sure that that is not what the Minister wanted, and if there is something that he can do I know that my constituents will be deeply grateful.

Julian Lewis: rose—

Sandra Gidley: rose—

Mike O'Brien: We need to make judgments on fluoridation based on the evidence. Stories always go round that can frighten people, and we have seen in this country a whole series of scare stories about vaccinations that resulted in a significant number of people being frightened out of giving those vaccinations to their children. We need to ensure that we consider the evidence, that we base our judgments on the clinical evidence and that we ensure, too—

Andrew Lansley: The Minister will know, not least from what my hon. Friend the Member for Mole Valley (Sir Paul Beresford) said, that there are Conservative Members who agree with the principle of fluoridation. However, the point is not that we should judge the evidence that suggests that it makes a positive contribution, but that the legislation makes it clear that there should be a process of public consultation. There was such a process in Southampton and Hampshire, but it began with the strategic health authority setting out the evidence in support of fluoridation and it ended with the SHA saying that it remained convinced by the same evidence.
	The consultation process therefore added nothing at all: what is the point of consultation when a decision has been made already? The Minister and the health authorities need to think about that again and accept that, if evidence is to be presented in a public consultation process, people must be given a more objective opportunity—either through a referendum or some other means—to make their views known.

Mike O'Brien: The difference between the hon. Gentleman and me on this is not as great as he makes out. I agree that the people who make decisions must take on board the views expressed by local people in the public consultation process. The process is not a referendum—

Mike O'Brien: By the sound of it, the hon. Gentleman is committing the Conservative Front-Bench team to referendums all over the country. I believe that, when local people are consulted, those who make decisions need to take on board the views that are expressed—and, indeed, the votes that are taken—by people in local areas. Those views are important, and the people who make decisions must consider them and give them due weight, but they are not binding in the way that a referendum would be.

Mike O'Brien: The Conservatives are proposing referendums once again. They want one on Europe, and now they seem committed to one on fluoridation as well. The important point is that we are working with the dentistry profession. There were difficulties following the 2006 contract—I do not dispute that for a moment—but we are now working with the dentistry profession to ensure that we produce a system of NHS dentistry that is right for England and the whole UK.
	The Government are committed to providing high-quality dentistry for everyone who wants it. As I have said, in the past two years, we have increased funding by some 20 per cent., or about £385 million a year. Although about 90 per cent. of dentists continued with the NHS after the new contract was introduced in 2006, others did not. That led to an initial fall in the number of people able to access an NHS dentist—a fall that is now quickly being reversed. New practices are opening across the country. The Conservative Opposition would like to paint a picture in which things are the same as they were two years ago, but that simply is not the case. In fact, if Opposition Front Benchers want to see for themselves, I invite them to go round the corner from the House of Commons to Horseferry road, where a dentist's has opened today.

Norman Lamb: The Liberal Democrats will support the motion tonight. We will support it, first, because it is rightly critical of access under the current contract. The Minister referred to statistics suggesting that 90 per cent. of patients are able to access dentists, but the fact that there are 10 per cent. who cannot should be a cause for concern. As my hon. Friend the Member for Manchester, Withington (Mr. Leech) said to me, if that was the case with access to GPs, there would be an outcry. For people who cannot access an NHS dentist, that creates a very real problem and the Government should not be satisfied with the current levels of access.
	The motion is right to stress the importance of piloting before introducing change, something that the Government failed to do when they introduced the contract. That is one of the reasons why it was so much resented by the dental profession. The motion is right also about the objectives. The objective should be improving oral health and introducing incentives for preventive care. The Minister rightly pointed out the importance of all dentists behaving professionally, but it must surely make sense for the system to ensure that the incentives are in the right direction to encourage and incentivise dentists to do the right thing. The motion is also right in identifying the need for an element of capitation-based funding and patient registration, and the importance of establishing a long-term relationship.
	However, the motion falls short in two important respects. First, it says nothing about oral health inequalities. That is an issue of fundamental importance, about which we on the Liberal Democrat Benches feel very strongly. Resources should be targeted at areas of greatest need, and the motion is silent on that. Secondly, on the face of it, the proposal to reintroduce dental screening programmes in schools looks appealing, but it is wrong and should not be introduced. If we are moving into an era where public finances are stretched and where we have to ensure that every penny is spent effectively, the Conservatives should think again about this. All the evidence suggests that school dental screening is ineffective in achieving the objectives.
	I have already referred to the survey undertaken by the oral health unit in 2002, but that is not the only research. There was a report in 2006 which concluded that the majority of the children studied
	"derived little benefit from the school dental screening programme in terms of attending the dentist, and receiving treatment for their carious permanent teeth. School dental screening also fails to address inequalities in the prevalence of untreated disease and utilisation dental services."
	An even more recent survey in 2008 concluded:
	"The evidence from the UK and elsewhere is that while the concept of dental screening is attractive to policymakers, there is no scientific evidence that it leads to improvements in health, either for individual children or for the child population."
	The Conservatives should think again. They are committing resources to something that has no evidence base to it whatsoever.
	This debate follows on from the Steele report in June. The Government deserve credit—it was an inspired move by the previous Secretary of State to appoint Jimmy Steele to undertake the review. It has been an independent process that has managed to secure the trust and respect of the dental profession and it has been stronger because of that. The recommendations of the report have secured widespread support. But the outcome of that report should embarrass Ministers, because it demonstrates that their repeated claims, made here on the Floor of the House, that the contract was working were nonsense. Back in 2007, the then Health Minister, now the Minister for Regional Economic Development and Co-ordination, the right hon. Member for Doncaster, Central (Ms Winterton), said:
	"We know that NHS dentistry is expanding, and that new contract is working."—[ Official Report, 26 June 2007; Vol. 462, c. 154.]
	The former Secretary of State for Health said in February 2008:
	"Access to NHS dentistry is getting better all the time."—[ Official Report, 5 February 2008; Vol. 471, c. 772.]
	Those comments fly in the face of reality, and now the authoritative Steele report, which the Government accept, demonstrates that many claims by Ministers and the resistance to any challenge to the workings of the contract were nonsense.
	Professor Steele highlights a number of issues. First, he points out that access is variable. In many parts of the country, access is fine and people can get to an NHS dentist, but in many other areas that is not the case. Steele makes particular reference to rural areas, where, according to a  Which? survey that the report mentions, just 29 per cent. of dentists are taking on new NHS patients. We should be concerned about that. It compares with 46 per cent. of dentists in urban areas.

Mike O'Brien: I am grateful to the hon. Gentleman for giving way on that point because my hon. Friend the Member for Carlisle (Mr. Martlew) raised a question about how people access dentists. Before 1990, when registration payments were introduced, dentists kept lists of their patients for their own purposes. Many dentists now keep such lists and regularly write to their patients for their own purposes. We are talking about a payment for registering—a payment to the dentist. Many dentists keep their lists anyway, and therefore people access and keep in contact with their dentist, who may write to them regularly to bring them in for check-ups and so on because they have their own list.

Norman Lamb: I note the Minister's point, but my central point is simply that many people, particularly those in rural areas, struggle to access an NHS dentist—whether or not they can register. We should all agree that that issue must be addressed.
	The second issue that I shall deal with from the Steele report concerns the original claim from the 2006 contract—that its operation would take dentists off the treadmill and focus on prevention and oral health. In fact, the contract's focus has been on paying for activity. On page 5 of his report, Professor Steele says:
	"So long as we see value for taxpayers' money as measured by the production of fillings, dentures, extractions or crowns, rather than improvements in oral health, it will be difficult to escape the cycle of intervention and repair that is the legacy of a different age.
	Making the transition from dental activity to oral health as the outcome of the NHS dental service will be a challenge for everybody, but it is essential if NHS dentistry is to be aligned with the modern NHS."
	In other words, he is saying that the contract fails to achieve that. That shows that its introduction was an enormous mistake.
	The truth is that this contract has set back good dental health for some four years because of its failure to encourage and facilitate preventive work. Indeed, in many respects preventive work has been sidelined. The report says, on page 22:
	"Perhaps the greatest surprise relates to the position of a scale and polish as part of a Band 1 charge. Many regular NHS patients told us they are paying privately for this treatment with a hygienist."
	The Government can easily criticise the dental profession for that, but that is the reality as a result of the contract: it is not facilitating preventive health care under the NHS. Dentists have been overwhelmingly critical of the contract—a view reinforced and confirmed by the Steele report, which refers to 86 per cent. of dentists feeling that they are still, in effect, on the treadmill. That is not exactly an overwhelming vote of confidence in the Government's contract.
	According to Professor Steele's vision for NHS dentistry, the focus should be ruthlessly on oral health—which was not ultimately a central feature of the contract—as well as on quality, prevention and continuity of care. On page 6, he says:
	"The incentives for dentists are not as precisely aligned as they could be to a goal of oral health and consequently there are inefficiencies within NHS dentistry. The pathway we describe should be supported by an altered contractual structure for dentists. We therefore recommend that dental contracts are developed with much clearer incentives for improving health, improving access and improving quality."
	Labour Members may simply refer again to the need for dentists to act with professionalism, but, as policymakers, we must surely ensure that the system incentivises the right things—preventive care and good oral health.
	Steele argues—I am not entirely clear whether the Conservatives support him on this—that we should work to develop the current contractual framework instead of throwing it out and starting all over again. Perhaps the Conservative spokesman can clarify their position on that in his closing remarks. If we throw the baby out with the bathwater and start all over again, there is a real danger that a further range of perverse consequences will follow that are hard to imagine at this stage. Professor Steele's central plea is to conduct a pilot and then apply the findings, which must surely be the way forward.

Norman Lamb: To some extent I am reassured by that intervention, but in due course I will come to something that causes me concern about the Government's continuing approach, and the Minister might want to intervene on me again then.
	One of the main current problems is the enormous variability in the quality of commissioning. I agree with the Minister that there are examples of very good practice, but according to most people the norm is that of not very good practice, in which commissioning has not been developed and the PCTs almost sideline dentistry and consider it of little central interest. That is part of the problem. In its paper published yesterday, the British Dental Association referred to the short tenure of staff. It stated that more than a quarter of PCT dental leads had been in post for less than a year, and the average was just 3.4 years. That turnover prevents any mature culture or understanding of the potential of commissioning from developing.
	My hon. Friend the Member for Romsey (Sandra Gidley) made the point earlier than an enormous percentage of PCTs do not feel that they have enough scope to innovate under the contract. The examples of the few PCTs that have innovated suggest that there is scope to do that, but for some reason best practice has not spread around the country. There is therefore a significant shortfall in the quality of NHS dentistry compared with what is potentially achievable.
	Along with a mass of poor quality PCT commissioning groups, there are none the less some PCTs that are doing really impressive, innovative work and making real progress. In Bradford, for example, the PCT has worked with the profession with collaboration as an important principle. It has developed a system that has less reliance on the measure of units of dental activity and created a blended contract with quality measures. That is possible under the existing contract, but most PCTs have not taken advantage of the scope available to them. The PCT in Bradford has developed effective care pathways, which are essential to proper treatment, particularly of those with poor oral health.
	Salford is another PCT that has been proactive, and part of Birmingham is providing an impressive lead on dental public health. Accredited practices have been established there, and some of the money going to dentists is given on the basis of their practices achieving quality and engaging in preventive work. Tower Hamlets PCT has also been doing good work. Those are the areas from which we ought to be learning what is possible in the way of good-quality preventive care and a focus on oral health. That practice needs to be spread out across the country. The approach has to be collaboration between dentists, PCTs and Government to pilot and then spread out good practice.
	The concern that I referred to after the Minister's intervention relates to the dental access programme. It appears that the Department of Health is up to its old tricks again of not collaborating and of imposing an approach against the wishes of the profession. The BDA has specifically expressed its concerns to me, and no doubt to others. It states that the Department has attempted to design a new contract in a very short space of time, but that it is utterly controlling and far too prescriptive. It tells me that the Department started work on the new contract in April, but it was not until July that the BDA got to see it. That is precisely what we are all complaining about and why Steele complained so much about the need for collaboration rather than imposition from above.
	The BDA says that the Department now appears reluctant to make further changes. It advised the Department in July—I believe that it met the Secretary of State—that it should use the existing contract, warts and all, to get the access programme running and then seek to effect improvements to it. Now we have got to the extraordinary and ridiculous position that the BDA is unable to endorse the new contract. Incredibly, practices that are tendering for the new contracts are unable to see them during the tendering process. How daft is that?
	Despite its total frustration with the Department, however, the BDA stresses that it has an absolute commitment to engage with the Steele reforms and work with the Government. The Minister made the point in his intervention that the Government are determined to learn lessons and pilot schemes before introducing them. Will he look again at the access programme to ensure that it is introduced in collaboration with the BDA, rather than against resistance from it, which would be entirely counter-productive?

Mr. Deputy Speaker: The House will be able to do its own maths. We have about 50 minutes—just under—and five Back Bench Members are wishing to contribute. Perhaps everyone will bear that in mind.

Charlotte Atkins: The House's last debate about dental services took place in December 2008. It was on a report from the Select Committee on Health that followed an inquiry on which I persuaded the Committee to embark. The review that arose from the criticisms made in the report was brilliantly led by Professor Jimmy Steele who, as a clinician, teacher and researcher, had the breadth of vision to pull off a report that is comprehensive, authoritative and widely applauded. This debate gives us a good opportunity to consider what Steele said in his report. It is ironic that the planned Opposition day debate on dentistry in July was pulled in favour of a seemingly more newsworthy issue. Dentistry had to take a back seat.
	Professor Steele nailed a few myths in his report. First, the media have told us that hordes of dentists have been so disgusted with the NHS contract that they have converted to 100 per cent. private practice. In fact, as Professor Steele says, the loss of NHS provision was very small indeed—just 4 per cent., which is hardly a mass exodus.
	Secondly, we were told that no one could find an NHS dentist. Clearly, access to NHS dentistry is a problem. However, the Steele review found that it is not a universal problem, and that it is concentrated in some areas. The Which? survey, on which the Minister commented, demonstrated that 88 per cent. of people who wanted to access a dentist could do so.
	Access to NHS dentistry is now firmly the responsibility of local PCTs. I applaud that, unlike the Opposition, because prior to that it was at the whim of individual dentists where they practised and whether they provided NHS services, private care or a mixture of the two. The PCTs have been given the responsibility to ensure that local demand is met. When they were first given the responsibility for commissioning, a lot of PCT mergers were happening, and that was unfortunate because the commissioning of dental health services was put on to the back burner. Dentistry did not get the priority in the NHS that it deserves—indeed, it never has done. More money has gone into dentistry, but it is still a very small part of the NHS budget even though dentistry is very important to people, not only because of the pain bad teeth can cause, but because having a mouthful of such teeth—although, happily, fewer people do so these days—can cause a real lack of confidence. The PCTs are now getting their act together, but many challenges remain.
	Yesterday a survey by the British Dental Association's local commissioning working group was published. Like the Steele review, it was initiated by the Health Committee's report. The survey found, as other hon. Members have said, that 60 per cent. of commissioners and 77 per cent. of local dental committee secretaries said that the national dental contract did not allow sufficient innovation and flexibility, so it is very good news that an effort is being made to introduce more innovation. We must work together to develop that innovation and flexibility.
	The survey also contained some good news. There were positive attitudes towards liaison between practitioners and commissioners. Related research by the BDA identified a broad consensus on the priorities for dental commissioning—improving access, especially for new patients, and targeting areas of high deprivation. That would not happen if dentists were allowed to locate wherever they wanted, instead of the PCT being the driving force. We need to build on that consensus, and Professor Steele's report provides an excellent starting point.
	The 2006 reforms addressed three key issues. The first gave responsibility for planning and securing NHS services to local PCTs, and that is really important. It means that the local health service can take account of local need. My PCT was very responsive to my concerns about one particular town, Biddulph, which did not have an NHS dentist, and we now have an excellent service there.
	The second issue was patient charges. In the past, patients had to steer their way through 400 separate charges. Many could not tell whether they were receiving NHS treatment or private treatment, because the charging system was so complicated. In 2006, those charges were reduced to three bands. These were simpler and less confusing for patients, but they could provide perverse incentives for patients to store up their dental problems and delay visits to the dentist. We need to address that problem.
	The third issue that arose from the 2006 reforms was connected to the units of dental activity. Dentists rightly complain that UDAs have created a new treadmill, with a possible incentive to provide treatments that are clinically no better than a lower band alternative as a way of increasing their practice payments— [ Interruption. ] I am not suggesting that dentists are pulling teeth because it is financially advantageous for them to do so.
	Professor Steele is right to propose more charging bands and a better continuity in the relationship between patients and dentists via a more formal registration system. The existing contract framework can be developed to allow payments for improving oral health, continuing care responsibility and better quality, as well as for increased activity. The Government must work with the profession and pilot these new incentives to ensure that any problems are quickly resolved.
	I had the perfect preparation for this debate, because I visited my local dental practice, as a patient, just two weeks ago. I attend TLC 4 Smiles, in Leek, which has eight surgeries with four full-time dentists, as well as full-time hygienists and therapists. It covers about 20,000 patients and has existed for more than 10 years. I am glad to say that I signed up as its first NHS patient. On that occasion, my dentist was Dr. Sophie Mitchell. She is a delightful lady who gave me a complete and comprehensive examination—clearly checking for oral cancer—an assessment of my dental health and then a scale and polish. She had no idea who I was until, when she had finished, I started talking to her about the Steele review. I was amazed that she told me, quite voluntarily, that she had moved from being a 100 per cent. private dentist to a 100 per cent. NHS dentist. When I left, I was offered an appointment in a year's time. That is what we need from our NHS dentists: good access, prevention and high-quality provision for the whole family.
	The Opposition motion proposes the reintroduction of school dental screening programmes. I agree with the hon. Member for North Norfolk (Norman Lamb) and the Minister that that is just window dressing. Those programmes have been proved to be ineffective, which is why they were stopped. If the Opposition are really interested in increasing preventive care, improving children's dental health and reducing dental health inequalities, they should be proposing to increase investment in Sure Start and similar initiatives and pushing the fluoridation of water supplies. Sure Start brings together health, education and social services to help pressurise mothers with children under four. It is the perfect vehicle to promote good, early oral hygiene alongside good access to NHS dentists. Fluoridation of water in Birmingham has provided huge benefits to children, compared with unfluoridated Manchester. The figures are very clear on the benefit of fluoridation.
	Fluoride toothpaste has also made a significant difference, and I commend my local PCT, NHS North Staffordshire, for its work to promote good dental health. I have joined it in wet and windy supermarket car parks and in town centres where its representatives have engaged with shoppers on oral health issues. It also attended my recent health MOT days, which are events that I have organised to promote public health, and I am grateful to NHS North Staffordshire for having the forward thinking to provide the health professionals who carried out health checks, such as on blood pressure, body mass index, cholesterol and blood sugar levels. We had an amazing response. During the two MOTs that I organised, more than 800 people turned up, and the dental health team played an important role at the events. I put on the record my thanks to PCT chief executive Tony Bruce, to Lesley Goodburn and to all the health professionals, including health visitors and district nurses, who worked so hard to make those events such a success.
	One of the criticisms in Professor Steele's report is that PCTs are no good at communicating with people about how to find a dentist. I am pleased to say that my PCT, having awarded a new NHS contract to two doctors in Biddulph—Mr. and Mrs. Keen—was very proactive in advising potential patients on how to sign up for that excellent NHS service.
	Through my local newsletters I was able to hand Mr. and Mrs. Keen the names of about 500 families looking for an NHS dentist in Biddulph. Very quickly, they signed up thousands of patients, many of whom had not been to a dentist in years. One constituent—a man in his 40s—told me that he had not been to a dentist for well over 20 years, after a bad experience as a youngster. However, the pain that he was in and the persuasion of his girlfriend finally led him to pluck up the courage to go. The Keens did such a fantastic job that he has never looked back. The Keens in Biddulph and TLC 4 Smiles in Leek are the modern face of NHS dentistry. As a Government we must do all that we can to support them.

Paul Beresford: I will be mindful of your point that I will have to scurry along a little, Mr. Deputy Speaker.
	I should point out first that I have a declared interest. I was going to be succinct and not touch on fluoride, but I can hear a hobby horse being saddled up in the Chamber just along from me, and I am bothered that my hon. Friend the Member for New Forest, East (Dr. Lewis) will have the blinkers on himself rather than the horse. In this case I support the Minister, which is probably damaging for him. He is absolutely correct: the case that was raised in the intervention was a consultation. Consultation is a normal approach for local government and the NHS in many areas throughout the country. There is an ongoing consultation in my area about the hospitals and hospital services. That is the correct way to do things, and the Water Act 2003 was adapted as it went through so that that approach would be adopted.
	In the case of fluoride there is a good reason for that, which is, as the Minister lightly touched on, that the scare tactics and extraordinary stories used by the opponents of fluoride frighten people. I have been in the field for some considerable time and I have heard accusations that fluoride makes people sterile—accusations which make every man deeply worried—that it is used as a poison, that it makes the tea taste strong or weak, or just different, and so on. In the consultation, therefore, as in most local government consultations, the responses were checked to see whether they were valid.
	Perhaps the silliest example is from some years ago, when a friend of mine was discussing fluoride at a big public meeting. He came through with all the statistics and so on, but at the conclusion of the meeting a gentleman got up near the back of the hall and said that he had been doing his own research too. He had researched a coastal town without fluoride, where predominantly elderly people lived, and a new town with fluoride, where mostly young people lived. He said that the VD rate in the young town was higher than in the old town, and that, therefore, putting fluoride in the water supply led to venereal disease. The disturbing thing was the number of people in the hall who seemed to agree with that rather weird synopsis of the decision.
	To get back to today's debate, there is much that I do not have to say, because my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), backed to some degree by the hon. Member for North Norfolk (Norman Lamb), has covered many of the points. The dentists are very upset. As the Minister accepted, many of them opted out, hedging over signing the contract. His predecessor set up an implementation panel that is supposed to ease the way through, but we have not heard anything about that.
	Local commissioning has become the done thing. There were 300 PCTs, but they were reduced to about 150, which caused chaos. Most of the PCT officials were complete dental novices and there was considerable confusion. Many PCTs are now doing their own thing—I suppose that we could call it 150 variations on a theme. The extra bureaucratic cost of all those little PCT units struggling to do their own thing on a muddled contract seems obvious.
	One of the problems is that dentists are paid by units of dental activity, which are allocated, probably by a non-dentist, in ranges of supposed difficulty of task. How one could get the same UDA for a molar root canal, which probably takes an hour and a half to complete properly, assuming that it is not sitting on an infection, and for the alternative solution, namely 15 minutes for an extraction, is beyond imagination.
	In addition, after asking to get away from the treadmill, dentists found not only that they were still on it, but that it had an allocation of UDAs. Some of those UDAs were low and, as my hon. Friend the Member for South Cambridgeshire pointed out, the dentists completed the tasks early, then turned patients away because they had run out of UDAs. Perhaps more seriously, however, others failed to meet their targets. They suffered clawbacks, and the deficits were loaded on to the contract target for the following year. That is worse than any treadmill that they might have been on before.
	A number of dentists have had considerable financial difficulties, and the realisation that many of the UDAs had different values in different practices only added to the confusion and discontent. Oddly enough, most people—including dentists—do not like being paid lower rates than their colleagues for performing identical tasks. I understand that a few primary care trusts are correctly trying to iron out that problem, but many have not bothered.
	The new, untried contract has been mentioned—the so-called Warburton access programme. Understandably at this stage, the British Dental Association is advising against any dentist signing it. As I understand it, dentists feel that the new contract gives the PCTs even greater control over dental ownership and practice. Research by a number of the dental media, such as  Dentistry magazine, suggests that the relationship between many PCTs and dentists in many areas is extremely poor.
	Because of the contract's structure, a dentist gains the same number of UDAs for a patient who needs one filling as for a patient who needs 15. There is therefore an understandable reluctance among dentists to tackle new patients who might present with extremely complex work. The amount of more complex work being undertaken has therefore dropped, and many of the NHS laboratories that provide back-up services are suffering a rather cool freeze.
	It must be said that some dentists and some PCTs appear to have made the system work. Indeed, some have been so successful that they have been accused of working the system, rather than making the system work. The comments about "gaming" that have come out of Richmond House are not helpful. Added to that, dentists are feeling somewhat persecuted because, when they look over their shoulders, they see that the General Dental Council—the policing organisation—has 24 members, yet only three of them are dentists or have dental experience. They also see that the National Institute for Health and Clinical Excellence, the quango that has proclaimed on dental recall intervals, does not even have a dentist among its ranks.
	In England, NHS dentistry is a world-class mess. I firmly believe that we need a public dental service. Ministers, however, measure access by the numbers of treatments. I believe that the measure should be the number of dentists who offer NHS dentistry as a choice for patients. Registration would enable such a count, and that would be the case whether the patient chose NHS treatment or private care. That is the key point: the patient should have the choice. A decayed tooth filled with an NHS amalgam or with a private porcelain inlay is still a restored tooth.
	There is much world-class dentistry provided in this country. Much of it is leading-edge advanced dentistry. We have world-class dental schools training students in world-class dentistry. They are producing porcelain and composite restorations, and beautiful world-class endodontics with microscopes and rotary nickel titanium instruments. They also produce carefully crafted obturations, inlays, onlays, all porcelain restorations and implants. The sad thing is that, given the present system, those students will move out into the real world of UDA targets, amalgams, high-speed endodontics and extractions. We need to bring back choice for patients. The blinkered view that just because it is the NHS it is best completely blocks the patient's opportunity for choice. I hope that those on both Front Benches will think very carefully about that.

Eric Martlew: Thank you for calling me to speak, Mr. Deputy Speaker. If you think I am going on too long, you can remind me to sit down.
	The last time that I spoke on dentistry was in the spring of 2006, when my constituency had a major problem of dentists opting out. There was one disgraceful incident in which a dentist who had done so wrote to his patients and told them that they had to come and apply the next day, and that if they did not, they would not get on to his list. He was actually giving out raffle tickets to the lucky ones who were going to stay with him.
	Since then, however, things have improved greatly. We now have about 10 new dentists in Carlisle and Penrith, with more on the west coast. We have a large practice staffed by European dentists right next to my office in the centre of the city. They are not Polish, but German. The reason why the Germans are coming over here is that they can make more money working for the NHS in this country than they can working as dentists in Germany.
	We have progressed greatly, and I was particularly pleased to receive an invite to the opening of the Carlisle dental centre on 25 February this year, which I will always remember. It is not only a multi-million pound emergency centre, but part of the Cumbria and Lancashire dental school, so we are now training dentists for this rural area. One of the arguments for training there is, "Where they train, they settle." In contrast to the Conservatives, who closed two dental schools, we have opened two of them, so things have improved greatly—and rightly so. I worry about what would happen if a Conservative Administration came in, because we know that they started the rot when they broke the contracts of NHS dentists—I know that that goes back a long time—and closed the dental schools. We have to ensure that that does not happen again.
	Fluoridation, which is an issue that angers me, has been discussed. I agree with the hon. Member for Mole Valley (Sir Paul Beresford) on that subject. I remember that this issue was on the agenda when I was the chairman of a health authority more than 32 years ago, when I suspect that the hon. Gentleman was training as a student dentist. I suspect that he was told that fluoride improved the health of children's teeth, yet we have done almost nothing about it.
	On the west side of Cumbria, fluoride has been in the water for 40 or 50 years, and people are not dying early—if they were, it would probably be blamed on Sellafield rather than fluoride anyhow! The reality and fact is that fluoride improves the health of children's teeth. I suspect that most Tory Back Benchers would argue that fluoride should not be put in the water, yet it is a scientific fact that it works. My Government, however, have also failed to get this issue brought forward as it should have been. We should have encouraged water authorities to increase fluoridation year on year, but we have stalled. I remember voting in favour of fluoridation on a free vote in this Chamber about three or four years ago, but I suspect that no real progress has been made since then. Consultation will be used as an excuse for doing nothing. We must move forward on this issue.
	I shall speak briefly about charges, which have not been much mentioned. In fact, my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) mentioned them, but not in the context of how charges put people off going to the dentist. It is difficult to go to the dentist anyhow in that we know it is likely to be painful, but finding that there is a charge makes it worse, which shows the difference between the GP service and the NHS dental service. It may always have been the case, but we have to remember that some working people in this country simply cannot afford to pay the charges, so they will put off going to the dentist as long as they possibly can and then go to the emergency services.
	In an ideal world, I would stand up to say that if we are serious about universal access, we should abolish these charges. If I look to the future, however, I see other major priorities for the NHS and financial constraints on Government spending. Although this has been done to some extent, my appeal to the Minister is to give some assurance in her reply that a Labour Government will acknowledge the fact that many people find it very difficult to pay those charges, never mind going private. The hon. Member for Mole Valley spoke about patient choice—choosing to go private or choosing to go to the NHS—but if people do not have the money, there is no choice.

Julian Lewis: I do not know which of the following two slogans resonates more with you, Mr. Deputy Speaker, but I know which resonates more with me. There is "The people will decide" on the one hand, and there is "The people do not know what is good for them" on the other. "The people will decide" is the slogan that the Prime Minister used when he visited Southampton and was asked whether fluoridation would be imposed on the city of Southampton—and, by extension because of various configurations of the pipework, on 8,000 of my constituents in the town of Totton as well. It was a banner headline: "The people will decide".
	Well, the people tried to decide. They responded to the consultation on fluoridation in very large numbers, and, as I said earlier in an intervention, 72 per cent. of respondents decided that they did not wish their water supply to be fluoridated. The strategic health authority, however, decided differently. Its members do not live in the area affected by the proposed fluoridation, apart from, I think, one member of the board. This was supposed to be a decision for local people, but those non-local people decided that although 72 per cent. of respondents did not want the water supply to be fluoridated, fluoridated it would be. One thing that the leader of my party keeps saying—there is a resonant effect on society whenever he says it—is that people do not like being taken for fools. It does not matter whether politicians are attempting to fool them over dodgy weapons dossiers, dodgy expenses systems or dodgy consultations, but they do not like it.
	If the case for fluoridation of the water supply is as scientifically strong as its advocates make out, its advocates have been singularly unsuccessful in persuading people to agree with them. It may be that my hon. Friend the Member for Mole Valley (Sir Paul Beresford) thinks that I am blinkered because I do not believe in mass medication via the water supply, and it may be that he thinks that my constituents are foolish and believe all sorts of old wives' tales because they reject it; but, in a democracy, it is up to him and people who think like him, and people who think like the Minister of State, to persuade the people to do what they think is right. I am sure that the Minister believes passionately that it will help people to have their water medicated with fluoride. For all I know, he may be right—for all I know, he may be hopelessly wrong—but I am sure that he believes passionately that it is in the interests of people to re-elect a Labour Government at the next general election.

Julian Lewis: No, I will not. I am sorry, but the hon. Gentleman has had his go, and I have very little time.
	I am sure that the Minister believes that passionately, just as my hon. Friends believe passionately, that it is in the interests of the people to kick out this failing Government and elect the Conservatives. The one thing that we agree on in those contexts is that if we want those things to happen, we must persuade the people. We must give them the choice and the final say. What is more, if we are telling them that we are giving them the final say, we should give them the final say and not cheat them.
	After the Prime Minister came to Southampton, and after the decision was nevertheless taken that fluoridation was going to occur in our water supply, I tabled a parliamentary question, which was answered by the Minister who will wind up this debate. I asked what the Prime Minister meant when he said that local people will decide this question. The response was as follows:
	"The Prime Minister's statement serves to highlight the legislative requirements contained in section 89 of the Water Industry Act 1991 whereby a strategic health authority must 'consult and ascertain opinion' before requesting a water undertaker to increase the fluoride content of a water supply."—[ Official Report, 22 June 2009; Vol. 494, c. 722W.]
	When one looks more closely at the regulations concerned, one is made aware of the Water Fluoridation (Consultation) (England) Regulations 2005, and in particular regulation 5, which reads like something straight out of Orwell's "1984":
	"A Strategic Health Authority shall not proceed with any step regarding fluoridation arrangements that falls within section 89(2) of the Act unless, having regard to the extent of support for the proposal and the cogency of the arguments advanced, the Authority are satisfied that the health arguments in favour of proceeding with the proposal outweigh all arguments against proceeding."

Julian Lewis: My hon. Friend says "hear, hear", which is fine, but in that case why bother to consult at all, because what that really means is that the health authority knows best? If 72 per cent. of people say no but the health authority says yes, the health authority gets its way. If 82 per cent., 92 per cent., 99 per cent. or 100 per cent. of the people say no, my hon. Friend, the Minister and the people who think like them say, "Tough luck chaps"—and chapesses in these equalitarian times—"you're going to get it anyway." That is utterly unacceptable, and it is undemocratic.
	We on my side of the argument are denounced as reactionaries. Well, it is interesting to see the company we are in when we are denounced as such. I am a Conservative—I am, indeed, a right-of-centre Conservative—but Mr. John Spottiswoode, one of the most articulate and outspoken opponents of this locally, is a candidate for the Green party. Councillor David Harrison, the Totton county councillor, and the hon. Member for Romsey (Sandra Gidley), who is not in her place at present, are also not usually regarded as reactionaries; they are, in fact, rather prominent and articulate Liberal Democrats. The Hampshire county council overview and scrutiny committee is made up of a highly qualified collection of people, and it is seriously worried about the way in which this consultation has been carried out.
	Most interestingly of all, however, the right hon. Member for Southampton, Itchen (Mr. Denham), a member of the Cabinet of course, and the hon. Member for Southampton, Test (Dr. Whitehead) have both said that although they are personally in favour of fluoridation, they believe that a stop should be put to the process because of the lack of public support. I am not cynical enough to think that those two Labour politicians are saying such a thing just because there is a general election coming next year. I reject that view—I am sure that they are saying that out of principle. They are saying it out of principle, and so are we.
	I shall conclude by referring to the letter I was delighted to receive recently from my hon. Friend the Member for Hemel Hempstead (Mike Penning), who will wind up for the Conservatives. He wrote that he was "happy to clarify" our position on this issue. He stated:
	"there are serious questions to be raised about the methodologies employed"
	in the consultation and that
	"public consent is vital to the implementation of any compulsory fluoridation scheme. Communities should have to give their approval for any proposal before it is permitted to go ahead".
	That is the position of the Conservatives, whether or not every individual dentist on my own party Benches chooses to endorse it.

Colin Breed: I am pleased that so many areas of this country have had their access to dentistry improved, but that improvement has not been the experience of people in Cornwall, particularly those in South-East Cornwall, who for more than the past 10 years have seen a declining service in NHS dentistry. More and more dentists have retired and not been replaced, and many have left to go into private practice. The declining and appalling service that we have experienced has been raised in this House on many occasions, and it has been brought to the attention of the primary care trust. Even in its most recent strategy, it failed to put this service in its top 10 priorities.
	Some people who move to Cornwall, because it is such a nice place, suddenly discover that they cannot get an NHS dentist and decide, therefore, to hang on to what they have. As a result, some people travel back on a regular basis from Cornwall to north Devon, Reading, Bristol, Somerset and other places to see their dentist because they cannot access a dentist locally—the waiting lists prevent their doing so. That is not to say that we have not been given anything recently. Some emergency dental services have been provided—someone who is in dire pain and dire need might get in, within 24 or 48 hours, to receive some emergency services—but that is not good enough for people who want a proper NHS service. I am also pleased about the new dental school at the Peninsula medical school. I hope that—I think that there have been indications about this in the past—the fact that new dentists are being trained there might encourage them to stay after their training and, thus, build up the dentist population in Cornwall. I hope that that will happen through the NHS—if there is a compulsion for them to do NHS work when they have finished training, that might assist. However, there is no guarantee that they will remain NHS dentists or that they will remain in the area.
	It was no surprise that during the summer the last NHS dentist in Saltash in my constituency, which is the sixth largest town in Cornwall, left the NHS and went private. I just want to read part of a letter sent to me by the dentist, to whom I wrote asking for an explanation, which sums up precisely what so many have said today:
	"I have worked as an NHS dentist for 20 years, and had always imagined I would carry on working for the NHS for my whole working life. I would consider myself a caring professional, and I hope many of my patients would back me up in this statement. I had warned the PCT that I may have to go private if they could not help, unfortunately I think they may have wanted to rely on my better nature not to change at all."
	The dentist continues by saying that at a meeting with the PCT's commissioning and performance manager in June, he
	"asked if it was possible to have a child only [0 to 18 years] NHS contract and they declined. I also asked the PCT for an NHS contract to continue seeing those adults who were exempt from NHS payment charges [those receiving state benefits] and they declined this also. The targets that the PCT were asking us to achieve were unrealistic and we also want to spend more time with each patient, discussing prevention of oral problems and how to look after one's mouth. I thought long and hard...but...I had...to leave".
	Unfortunately, that has been the experience of far too many dentists in Cornwall, particularly those in South-East Cornwall. The Minister of State, Department of Health, the right hon. and learned Member for North Warwickshire (Mr. O'Brien), is not in his place, but he was suggesting that he might visit. I would welcome the visit to Cornwall of any health Minister—they could meet me or any of my colleagues—so that we can hunt down greater access to dentists. Greater access is simply not true down in Cornwall, and it has not been for years. It is about time equality of access was actually addressed.

Michael Penning: It is a pleasure to sum up on behalf of Her Majesty's Opposition on such an important debate, which has taken up so much of my time since I became a Front-Bencher. As we have heard, dentistry does not take up the largest part of the NHS budget—some £2.7 billion of some £110 billion is spent on NHS dentistry annually in this country—but it is something that affects nearly everybody in this country, whether or not they go private. I shall return to the comments made by the hon. Member for Carlisle (Mr. Martlew) about where I go for my dentistry in a moment, although I must say that he clearly does not know me very well.
	The shadow Secretary of State summed up very well the problems within NHS dentistry, which explain why this debate has been chosen by Her Majesty's Opposition so quickly after the summer recess. That was done—I shall come on to this in more detail in a moment—because we welcomed the Steele review, which the Government accepted in full. During the debate, I asked the Under-Secretary whether she accepted it in full, and she said yes. The Steele review is there, and I welcome it. I have spoken to Professor Steele since he published his review and I think that it was a very important way to look forward. It is visionary—it has similarities to Lord Darzi's review in that respect—although it perhaps does not have the detail that we were looking for about how we should implement some of those ideas. We have those ideas, and the shadow Secretary of State laid them out earlier.
	I want to touch on some areas to do with our policy on dentistry that we did not have a chance to discuss earlier and I also want to make comments on the contributions made by each individual Member who has spoken in the debate this afternoon. This has been a sensible debate. I have to admit that some of the comments that I have heard about how brilliant the availability of NHS dentistry around the country is seem to be anomalous to the letters and correspondence that I get and the comments I hear from dentists. As we heard earlier, provision is patchy and in some parts of the country it works well whereas in some parts of the country it is appalling. How can that be right in an NHS in the 21st century?
	Let us consider some of the comments that were made during the debate. I have been on the platform many times with the hon. Member for North Norfolk (Norman Lamb) to discuss dentistry. I was slightly surprised when he said that he did not quite know whether we were going to get rid of the contract, keep it, twist it or do whatever else with it. I have stood on the platform with him many times and said that the contract in its present form is unworkable, that it is a damaged brand and that it needs to be phased out. We intend to phase in the new contract alongside it. We will pilot the hours—the pilot is important—but we will not ignore the pilot, as the Government did in 2006 and appear to have done again now, and force something on dentists.

Michael Penning: I have said that there are very good things within Steele, but that how we implement what he is saying is much more difficult than simply saying, "I have a vision." We do not feel that one could leave the contract in this form, discredited as it is within the profession and around the country—it is discredited not only with patients but with dentists too. It is absolutely right to say that if we came in on day one and scrapped it, there would be chaos—there would. There is chaos in parts of the country now, but there would be more chaos. The new scheme needs to be phased in and to be piloted and dentists need to know from day one where we are going and we need to work with them, unlike what is happening at the moment.
	Let me touch on the school inspections, which have been commented on by my hon. Friends the Members for South Cambridgeshire (Mr. Lansley) and for Mole Valley (Sir Paul Beresford). If we only do school inspections and nothing else—if a dentist merely walks into a school, looks at a child's oral health and walks back out again—there is no point doing it. That is not what we are proposing. It has to be based on education, and on training for people in the schools and for the nurses in the schools. We also need to look inside that child's mouth—in many cases, sadly, they will never have had any oral expert look at their oral hygiene at all.
	I say to hon. Members and to people around the country—I have said it to the British Dental Association, too, so it is no secret—that if they think that it is acceptable for children in our schools today to have abscesses and rotting teeth at such an early age and for us to do nothing about it, they should come up with another idea—

Michael Penning: No, thank you. The hon. Gentleman has said enough from a sedentary position.
	If school inspections are so wrong, how come one in seven primary care trusts in this country still carry them out? They have made the decision to put their money where their mouth is and to still do that. That is very important.
	I also listened carefully to the hon. Member for Staffordshire, Moorlands (Charlotte Atkins), with whom I served on the Select Committee. I congratulate her on convincing the Committee to look into dentistry. I would have thought that it would have been an easy process—I would have thought that all Members of the Committee would have realised what a crisis there was.
	The important part of the hon. Lady's speech was her understanding of the problems with the unit of dental activity. The Select Committee saw the problems in having such a small group of bands. It is not good for the patient, because they do not understand exactly what they are paying for when they hear of someone who had a lot less treatment paying exactly the same. The bands have to be expanded, as we have said, but they also exert a perverse influence on dentists. What should they be interested in when they look inside a person's mouth—oral hygiene, or how much money the job will cost and how much they will get? I know that the Health Committee looked at that, because it was one of the biggest worries expressed by dentists.
	It cannot be right that dentists get paid the same to do one filling, or six. The money has to be based on the activity that is undertaken. Earlier, and again from a sedentary position, the hon. Member for Carlisle made it clear that he was worried that more extractions than fillings are carried out these days. In fact, there has been a 45 per cent. reduction in the amount of root canal work done in this country since the new contract came in.

Michael Penning: Thank you very much, Mr. Deputy—I am sorry, I mean Mr. Speaker. Perhaps "Deputy" is another word that I should not use too often.
	My hon. Friend the Member for Mole Valley knows so much about dentistry that sometimes it is very difficult for me to talk to him about these matters. He probably knows more about them than anyone else in the House, and I was very interested when he said that dentists were less worried about what happened when they ran out of UDA than they were about the money that is then clawed back. Although they may want to treat the new patients that come to them, the fact that they do not have enough UDA means that they are not able to.
	It is astonishing to me that, in the past nine months, we should have had two debates about the types of contracts that are out there yet hon. Members and the public still do not realise that, unless they are having treatment, they are not registered with an NHS dentist. In his report, Professor Steele made it absolutely and categorically clear that registration was crucial. He said:
	"We recommend that patients register in a continuing care relationship."
	However, you cannot have such a relationship if the dentist is not responsible for continuing care. If you only go to him when you have problems, he is not responsible for your continuing care. That is why registration is so important, and why we need to make sure that dentists, like GPs, are responsible for people's preventive care.
	Earlier, the hon. Member for Carlisle said, again from a sedentary position, "I bet he's always gone to a private dentist," but—

Michael Penning: Where people in this country go to the dentist is a matter for them, and I happen to be lucky enough to have an NHS dentist. In fact, most of the time my dental hygiene was looked after Her Majesty's armed forces. That care was not private either.
	In many parts of the country, people do not have the choice to go and see an NHS dentist. There is no point in being delusional about the fact that NHS dental provision is good in some parts of the country and bad in others. Sadly, the current system is fundamentally failing millions of people who would prefer to have an NHS dentist looking after their continuing oral hygiene needs.
	My hon. Friend the Member for New Forest, East (Dr. Lewis) defended local democracy to the hilt. He read out the relevant correspondence and my hon. Friend the Member for South Cambridgeshire, the shadow Secretary of State, set out our party's position on these matters. However, one specific thing would help to ensure that an awful lot more children got to see an NHS dentist—the removal of the ban that the Government introduced that prevents children from being seen only on the NHS.
	In a perfect world, NHS dentists would be available to everyone who wanted to see one, but the crisis is most serious when it comes to children. For a large proportion of the adult population, the damage has been done already, but children's dental care is the crisis area and that is why we would allow NHS-only contracts for children. That would have the important effect of encouraging dentists back into the NHS. We do not have a shortage of dentists in this country: what we have is a shortage of dentists willing to work in the NHS. Those are the facts.
	We train huge numbers of dentists. In his opening remarks, the Minister told the House how many dentists are being trained in this country at the taxpayer's expense, but as the hon. Member for Staffordshire, Moorlands said, they may not even stay in the NHS. We train them very well, with some of the best—probably the best—training in the world, but once they have done that training, they can walk away from the NHS and the taxpayers who pay for it. We must ask them to stay at least partly within the NHS; it is important that we do so. This has been an important debate. I am pleased that so many Back Benchers have—

Mike O'Brien: rose—

Ann Keen: I thank hon. Members for the high quality of this evening's debate. We may often disagree on the specifics of policy, but I hope that we none the less share a commitment to providing high-quality national health service dentistry to everyone who wants it. Dentistry has come a long way in recent years, although we all know that there is still further to go. The Government believe that the best decisions are those made closest to the ground. That principle of devolved, local decision making is at the heart of everything that is happening in the national health service today, and at the heart of NHS dentistry.
	The new contract in 2006 gave primary care trusts the power and the responsibility to shape local dentistry services to fit the specific needs of their communities. Many have risen to that new challenge and are providing excellent NHS dental services. I could give many examples; some have been given in the Chamber this evening. South Tyneside primary care trust, like much of the north-east, has a history of ensuring good access to NHS dentistry, but now the PCT is working with local dentists to improve the quality and efficiency of the services that it provides. The aim is to improve services for patients while providing best value for money.
	Although places such as South Tyneside are good, other areas are not as good, as we have heard today. Where progress is uneven, we need to go further. That is where Professor Jimmy Steele's review has proved so valuable. It has helped us to understand further the modern landscape of dentistry and the needs of the population, and that the focus of modern dentistry must be on prevention, the maintenance of oral health and quality. It also helps us to understand that different generations can have very different needs. We are asking our dentists for different approaches in light of that. We are starting to test the recommendations. PCTs that tender for new contacts so as to increase access to dental services are starting to place qualitative measures in their contracts. Depending on the results of piloting, we will start to roll out the Steele recommendations on quality to all contracts for dental services.
	In the past two years, funding for NHS dentistry has increased by the best part of £400 million a year. That is extra money going to the front line, and that gives more people better access to high-quality dental care. However, the issue is not only about spending more; it is about spending better. The national dental access programme is helping PCTs to get the most out of existing services, looking at how things are organised on the ground and offering advice and guidance on how they can be improved within existing budgets.
	The last time I stood at this Dispatch Box to debate dentistry was in December last year. I assured the House that access to NHS dentistry was about to increase. If I remember correctly, the Opposition did not share my confidence. Well, I am delighted to say that I was correct. The NHS information centre's latest statistics show that the number of people who have been able to see an NHS dentist has risen by 720,000 over the past year. I hope the House will believe me now when I say that the growth in access will continue in the years to come. We are on course to achieve and, indeed, surpass the Opposition's rather unambitious target of an extra 1 million people. Trust the Government and this party to do the job properly. Trust this nurse. People should always trust the nurse when she is telling them what we will achieve.
	We are well on the way towards replacing the access lost when a minority of dentists decided not to accept the new contracts in 2006, but we aim to go much further. Every strategic health authority is committed to making sure that by March 2011 everyone who wants a dentist can access an NHS dentist. We are committed to implementing Professor Steele's recommendations to improve both the quality of dentistry for patients and the working lives of dentists.
	In the time that we have left, I will endeavour to answer as many as possible of the questions that hon. Members raised. As is traditional, if I fail to answer any questions we will write to the Members who participated in the debate. The hon. Member for North Norfolk (Norman Lamb), speaking from the Front Bench for the Liberals, made a positive contribution and spoke about quality, prevention and inequalities. He reminded us of the importance of good negotiations with the BDA, and I take note.
	My hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins), who is known for championing dentistry in the House, and in particular fluoridation, spoke about TLC 4 Smiles for herself. She also mentioned a Mr. and Mrs. Keen, who were making a valued contribution to dentistry in her area. May I say to all in the House and to any journalists who may be present that I have only the one job. On this occasion I can also vouch for my hon. Friend the Member for Feltham and Heston (Alan Keen).
	The hon. Member for Mole Valley (Sir Paul Beresford), who spoke from his experience as a dentist and brought much experience to the Health Committee and the all-party group on dentistry, referred to the BDA survey. That survey also stated that relations between PCTs and dentists was very good indeed, citing 87 per cent. of cases that were reported. That report was published yesterday and we should acknowledge its findings.
	I thank my hon. Friend the Member for Carlisle (Mr. Martlew) for his comments on the improvements that have been made. He mentioned the important matter of charges, which is dear to the hearts of all Members, especially those on the Labour Benches. All children and about 30 per cent. of adults are exempt from charges.
	The hon. Member for New Forest, East (Dr. Lewis) raised with typical forcefulness and passion the subject of regulations. I should point out that those regulations were passed in the House on a free vote. I cannot go further as the matter is subject to a judicial review.
	The hon. Member for South-East Cornwall (Mr. Breed) highlighted important topics. From next spring the PCT responsible for Saltash is commissioning new services that will offer care to all sections of the population. He also mentioned that the new dental school in the south-west peninsula, part of the development of a dental education centre, is under construction in Truro. For the first time, dentists will be trained in Cornwall.
	Speaking from the Opposition Front Bench, the hon. Member for Hemel Hempstead (Mike Penning) stated that should the Conservatives be in government, dentists would be required to work in the NHS. I should be grateful if he would explain how long they would be required to do so and how he intends to achieve that.

Ann Keen: Those are very interesting comments, indeed. That proposal is similar, of course, to registration, because registration was in fact a payment to register. Our dentists today recall patients, and they have continuity of care, just as—

Andrew Lansley: Will the Minister give way?

Ann Keen: Yes.

Ann Keen: The registration was a payment. What we are still able to do is—

Ann Keen: My hon. Friend makes an excellent point. The proposal is certainly news to Government Front-Benchers today, but I think that we should expand on it; perhaps it is something that we should look at. It will be interesting to see how negotiations on it go with the BDA. Perhaps the Opposition will keep us informed, because much has been said today about the professionalism of our dentists. In fact, accusations have been made about the number of extractions that are deemed unnecessary.
	We admire our dentists and congratulate not only them on the real hard work that they do, but all the team who play such a role, including hygienists and, in particular, dental nurses. We note also their approach to health inequalities and their serious work with us and Professor Steele to implement the new contract. I have heard nothing from Opposition Members about inequalities. I have heard nothing that would actually—

Andrew Lansley: Will the Minister give way?

Ann Keen: Yes, certainly.

Ann Keen: I am not sure that the hon. Gentleman would be able to achieve that, because regulation might come into play. He cannot make such statements just to please himself this evening; he has to be able to fulfil them.  [ Interruption. ] I am sorry, but he does have to look at his subject area again, because it is just not possible to make that proposal tonight.
	We are talking about a team of people who work in our primary care system and are respected and valued in the community. Interesting points have been made today about dentists being asked to work up to five years for the NHS, and it would be very interesting to see how that might be expanded to include other health professionals and members of the health service work force.
	We want to congratulate all the dentists who have worked with the contract. It was a difficult contract to introduce, and it has been difficult for some people to implement, but our PCTs, along with our commissioners, are working for dentistry to be accessible for all. We have made a commitment that by 2011 all those who want a dentist will have access to a dentist.
	We have heard tonight, yet again, from a Conservative party that pays lip service to everything—

Question accordingly negatived.
	 Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.
	 Question agreed to.
	 The Deputy Speaker declared the main Question, as amended, to be agreed to (Standing Order No. 31(2)).
	 Resolved,
	That this House welcomes Professor Steele's review report and its endorsement that the principle of local commissioning introduced by the 2006 reforms provides a firm basis on which to develop NHS dentistry; agrees with the vision set out in the review of improving incentives to support dentists in delivering access and quality; acknowledges the Government's commitment to working with the dentistry profession and other stakeholders to ensure through careful piloting that it implements the recommendations in a way that delivers the best possible system for patients, dentists and the NHS; acknowledges that children's oral health in England is already among the best in the world; welcomes the commitment of the NHS to deliver access for all who seek it by March 2011 at the latest, supported by some £2 billion in central funding for dentistry, and understands that access is now growing again; notes that in the last four quarters the number of people seeing an NHS dentist in the previous 24-month period has grown by 720,000; further notes that the dental workforce is growing, with 655 more dentists working in the NHS in 2007-08 and a further 528 in 2008-09; and recognises the support that the dental access programme of the Department of Health is providing to clinicians and managers to help them rapidly expand NHS dental services where necessary.

That at this day's sitting, Standing Order No. 41A (Deferred divisions) shall not apply to the Motion in the name of Huw Irranca-Davies relating to Common Fisheries Policy.—( Mark Tami.)
	 Question agreed to.

That this House takes note of European Union Documents No. 15869/08. Commission Communication on the Proposal for a Council Regulation establishing a Community control system for ensuring compliance with the rules of the Common Fisheries Policy, and No. 15694/08, draft Council Regulation establishing a Community control system for ensuring compliance with the rules of the Common Fisheries Policy; and supports the Government's objective of ensuring that this proposal delivers stronger, proportionate, more effective control provisions which contribute to the long-term sustainability of fish stocks.—( Mark Tami.)
	 Question agreed to.

Ordered ,
	That Sir George Young be discharged from the Committee on Standards and Privileges and Mr David Curry be added .—(Mark Tami.)

Motion made,
	That Dr Richard Taylor be a member of the West Midlands Regional Select Committee .—(Mark Tami.)

Motion made,
	That Mary Creagh be discharged from the Yorkshire and the Humber Regional Select Committee and Mr Austin Mitchell be added.—( Mark Tami.)

Motion made,
	That Linda Gilroy be discharged from the South West Regional Select Committee and Roger Berry be added.—(Mark Tami.)

Motion made, and Question proposed, That this House do now adjourn. —(Mark Tami.)

David Tredinnick: I am grateful for the opportunity to address the House on this important issue and I am glad to see the Minister in her place this evening. I wish to consider the House of Lords Science and Technology Committee's report on complementary medicine 10 years on. I shall cover three points: regulation, how we can widen the number of therapies available in the NHS, and the case for more research.
	The Committee first met in 1999 and its report states in section 5.53:
	"The Osteopathic and Chiropractic professions are now regulated by law. It is our opinion that acupuncture and herbal medicine are the two therapies"—
	which at this stage would most benefit from regulation. I shall start by considering the position of osteopathy and then of herbal medicine.
	The Osteopaths Act 1993, mentioned in the report, has been a huge success, but there is a postcode lottery at work. Only 16 per cent. of primary care trusts allow GPs to refer patients to osteopaths on the NHS and an additional 25 per cent. allow GPs to refer patients in exceptional cases. That is wrong, and I ask the Minister to address the problem. Where osteopathy is used in the NHS, its use increases year on year, suggesting patient and GP satisfaction, so the barrier is in the approach of the primary care trusts.
	The Minister will be aware that the report from the Department of Health steering group on the regulation of acupuncture, herbal medicine and traditional Chinese medicine was published on 16 June. This followed the work done by Professor Pittilo and the late Lord Chan on herbal medicine and Chinese medicine respectively. The report recommended that in the interests of public health and patient safety all practitioners should be required to attain high standards of competence through the Health Professions Council as soon as practicable.
	The Government responded by launching a consultation that will seek views on whether a regulatory system should be established. What is the position of that consultation? I suspect that it has been pushed gently into the long grass. The regulation of traditional Chinese medicine, acupuncture and herbal medicine has been a long and arduous process on which many people have worked—I have met many of them—and we need to know whether the Government are still committed to the process. What is the likely timetable? If nothing happens, we will soon be in the ludicrous situation of the herbal medicinal products directive coming into force in 2011 without appropriately regulated practitioners.
	Another issue that we need to address this evening is homeopathy. Section 5.50 of the report says that therapies should be able to seek statutory regulation, and homeopathy is the one therapy in group 1 in the report—the Minister will remember that there are different classifications—that is not statutorily regulated. I am informed by the Society of Homeopaths, which is the largest organisation representing non-medical homeopaths, that there is a move towards statutory regulation through the Health Professions Council. Will the Government look favourably on that application?
	Homeopathy has had a long tradition in the health service; it was actually used by Aneurin Bevan—all those years ago—who helped to put it in the health service. However, homeopathy has been under attack, despite the new Royal London Homeopathic hospital. The hospital and those who support homeopathy have faced difficult times, not least the attacks by the so-called scientific establishment and a letter that purported to come from the NHS—it had the NHS logo on it—in May 2007 which was signed by many retired professors of medicine. That letter should never have been sent out under the NHS letterhead.
	Attacks have also been made on the efficacy of homeopathy. A letter was sent to the World Health Organisation warning against the use of homeopathy, but it ignored the very clear randomised, double-blind trials that proved that it is effective in the particular area of childhood diarrhoea on which it was criticised. Will the Government therefore be robust in their support for homeopathy and consider what can be done so that it is used more effectively in the health service?
	There are also serious problems in chiropractic, which one might call an assisted discipline to osteopathy. The General Chiropractic Council has been bombarded by complaints from bloggers—spurious complaints I would say—which it is obliged by law to investigate. I am very concerned that genuine complaints will not get through and that any practitioner, against whom a genuine complaint had been lodged, could continue to practise. Will the Minister look at this very unsatisfactory situation, which arose following an individual losing a court case against the British Chiropractic Association?
	I would like the scope of complementary and alternative medicine to be widened. Way back in 2001, when I spoke on this subject, I quoted a Minister as saying in Committee that:
	"Services that were considered outlandish several years ago are now almost considered to be part of conventional health care".—[ Official Report, Standing Committee G, 6 June 2000; c. 81.]
	That was in 2001. Now we have a situation in which we can move on even further. The Government have done well with the guidelines from the National Institute for Health and Clinical Excellence that allow for osteopathy and chiropractic for lower back pain. That is definitely a step in the right direction. It has come about only because of the rigorous research carried out, resulting in acupuncture and, as I said, osteopathy and chiropractic being made available.
	We now need to bring in other therapies and to ensure that they are made available. That can be done in different ways. The Complementary and Natural Healthcare Council has been set up to regulate some therapies, such as massage therapy, nutritional therapy, reflexology and aromatherapy. However, the numbers are less than expected. Can the Minister help in any way by publicising the benefits of this council to those who might join it?
	The Science and Technology Committee reported in four sections. I shall not go through all the different categories, but all those listed—I have reviewed them all—have some validity.
	Before turning to research, I want to focus on ethnic treatments, which are used by many people in this country. I am thinking of Chinese and Ayurvedic medicine. I want to look at how they are part of those cultures and at how those cultures look at the sky as part of their medical disciplines. Chinese medicine is closely aligned to feng shui, which is popular in this country and has a sub-discipline called "right directions", and it relies on Chinese astronomy and astrology. I was on the last parliamentary delegation to Hong Kong before we gave it back to the Chinese, where I met Chris Patton's Chinese astronomer and astrologer—it was important to the Chinese that he should have one. Ayurvedic medicine also has a long tradition of looking at astronomical and astrological factors, and Lahiri is the official astrological system of the Indian Government.
	In 2001 I raised in the House the influence of the moon, on the basis of the evidence then that at certain phases of the moon there are more accidents. Surgeons will not operate because blood clotting is not effective and the police have to put more people on the street.
	I am arguing for more research. I have been criticised for raising the subject, but the criticism is generally based on a misunderstanding. It is based on the idea that I am talking about the stuff that we see in the newspapers about star sign astrology, but I am not. I am talking about a long-standing discipline—an art and a science—that has been with us since ancient Egyptian, Roman, Babylonian and Assyrian times. It is part of the Chinese, Muslim and Hindu cultures. Criticism is deeply offensive to those cultures, and I have a Muslim college in my constituency.
	The opposition is based on what I call the SIP formula—superstition, ignorance and prejudice. It tends to be based on superstition, with scientists reacting emotionally, which is always a great irony. They are also ignorant, because they never study the subject and just say that it is all to do with what appears in the newspapers, which it is not, and they are deeply prejudiced, and racially prejudiced too, which is troubling.
	Over the past few years I have looked at the issue in detail, as well as at the impact of astronomy and astrology on western herbalism, as taught by Culpeper, whose book "Culpeper's Complete Herbal" has been in print longer than any other book in this country besides the Bible. There are now people who teach, such as Jane Ridder-Patrick, who published "A Handbook of Medical Astrology". They look at aspects of the subject and how it affects people's health. Whatever one believes personally, the issue is one that we should look into and consider. We must get away from this awful, mediaeval superstition.
	Finally, I want to appeal to the Minister to fund a little more research. Research into complementary medicine is usually done with individuals, but I am seeking perhaps £5 million and for the research to be placed with the King's Fund, or perhaps another body, for use in universities. It takes about £125,000 to fund a trial. At the moment we just do not know how effective some complementary medicines are in surgeries where different therapies are used. The Government have helped and some useful steps have been taken, but if we are really going to understand the best way of using such therapies, which are increasingly popular, we need more research. I appeal to the genial nature and the good judgment of the Minister to help in this way.

Gillian Merron: I congratulate the hon. Member for Bosworth (David Tredinnick) on securing this debate on the important matter of complementary and alternative medicine, which was the subject of an important report by the House of Lords Science and Technology Committee, which the Government welcomed at the time and responded to in 2001.
	I hope that the hon. Gentleman, whom I listened to carefully, will find it reassuring that the Government's position on complementary and alternative medicines, which I shall refer to as CAM, is the same as our position on mainstream medicines. First, decisions about care are best made by clinicians on the ground. Doctors and health professionals are best equipped to make the right choices for their patients, and local NHS services are best placed to decide which treatments will benefit their communities best. Secondly, the decision to embark on any course of treatment has to be made on the basis of robust clinical evidence. That means clinical trials, peer-reviewed papers, and guidance from the National Institute for Health and Clinical Excellence. Thirdly, the way in which the Department funds new research is through the National Institute for Health Research. The NIHR provides substantial funding for a wide variety of studies that meet strict scientific criteria and that reflect the needs of the national health service. Finally, we should always be open to new methods and ideas. That means using the NHS's world-leading innovation and research facilities to ensure that health professionals get the latest and best clinical information, and that patients get the best, safest care available.
	I want to address the main points that the hon. Gentleman has raised. On the question of research, as he has pointed out, the Lords Select Committee report made recommendations on strengthening the evidence base and investing more to encourage new research. The Department of Health is one of the largest mainstream UK funders of research into CAM. It is investing record sums in health research in general, with the NIHR spending nearly £1 billion in 2010-11. Our research strategy, Best Research for Best Health, is being delivered by the NIHR and has resulted in significant new funding opportunities for health research. A number of awards have been made in the past year or so in support of studies directly concerned with demonstrating whether specific CAM therapies work and whether they represent good value. That builds on the 100-plus projects that were funded in the past 12 years and recorded in the national research register.
	Current projects funded by the NIHR include a £1.3 million study into the effectiveness and cost of acupuncture, a £500,000 clinical trial into acupressure for the control and management of chemotherapy-related nausea and a clinical trial looking at the use of self-hypnosis by pregnant women to reduce pain and anxiety during labour. In each case, these awards have been made following rigorous peer review and in open competition.
	The Government also run a £3.4 million award scheme, which has supported 18 researchers, including those engaged in post-doctoral studies. They have completed a number of reports on topics ranging from acupuncture to Chinese medicine. In addition, the Department has funded research on the role of CAM in the care of cancer patients, and on the use of complementary medicine in primary care. It is safe to say that, if CAM researchers continue to come up with high quality proposals, there is no reason why they should not continue to attract NIHR support.
	The hon. Gentleman also referred to the roles that astrology and astronomy can play. I acknowledge that some forms of complementary and alternative medicines and thought consider that there is a link or relationship between astrology and their practice. An example is Indian ayurvedic medicine. I would say to him that, with this as with any other CAM, any proposals for research would be considered on their merits.
	The hon. Gentleman also raised the matter of access to CAM therapies. I confirm that we are committed to providing the most appropriate and effective treatments for patients. Complementary and alternative medicine therapies that have been proven to be effective, cost-effective and safe will be made available to patients. As he will know, it is a matter for local NHS organisations to commission health care treatments for NHS patients, as they are best placed to make decisions in the interests of their local communities. Primary care trusts manage 80 per cent. of the national health service budgets, and they are responsible for making the decisions on what treatments to commission and fund. They often have specific policies on the commissioning and provision of CAM. Within these policies, GPs can give access to specific therapies, provided that they are in the patient's interest. If someone wishes to receive a specific CAM treatment on the NHS, they should discuss this with their GP. Clinical responsibility for an individual's health rests with their GP, who must be able to clinically justify any treatment referral.
	I want to address the National Institute for Health and Clinical Excellence guidelines on complementary and alternative medicines. NICE has already agreed that where there is sufficient evidence to look at specific complementary therapies when developing clinical guidance for particular conditions, it will do so. The guidance focuses on a particular illness or condition rather than on the treatment or therapy. A good example are the recent guidelines produced by NICE on the management of non-specific lower back pain, of which I know the hon. Gentleman will be aware. These guidelines include consideration of treatments such as osteopathy, spinal manipulation and massage. NICE has already issued guidance on whether some complementary therapies do or do not add benefit in respect of specific conditions, including multiple sclerosis, antenatal care and palliative care.
	The hon. Gentleman raised a number of important points about the regulation of CAM. Regulation, whether it is statutory or voluntary, is primarily, of course, about patient safety. It is our duty to protect the public from poor or potentially unsafe practices. I note the hon. Gentleman's point about osteopathy and chiropractic treatments, which are currently regulated by law. Any future review of regulation would most likely examine whether the current arrangements are the most cost-effective way to manage public safety. No decisions have yet been taken.
	The Government have no current plans to extend statutory regulation to homeopathy. The hon. Gentleman raised concerns about a document recommending disinvestment from homeopathy, which was circulated using the NHS logo. I can confirm that our inquiries found no record of the Department having authorised the use of the NHS logo and that those who originated the document were asked not to circulate it any further. They were advised about the use of the logo in future and chief executives of trusts were also informed that the document does not represent Government policy.
	Although we have committed to considering statutory regulation for herbal medicine and acupuncture, which carry significant risk because they involve skin piercing and/or the ingestion of potentially harmful substances, we have no current plans, as I have said, to include homeopathy. To clarify, that is because statutory regulations are a priority, I believe, for those conditions where there is a particular risk of harm if treatment is placed in the wrong hands. A consultation has been launched on whether practitioners of acupuncture, herbal medicine and traditional Chinese medicine should be regulated by statute. It closes on 2 November this year, and we will respond in due course.
	Other schemes that the Department supports include the Medicines and Healthcare products Regulatory Agency's new traditional herbal medicines registration scheme, which will make it easier for consumers to identify regulated products. We will also continue to support the work of the Complementary and Natural Healthcare Council, and we have funded its start-up costs. The CNHC is a voluntary registration body that is open to massage, nutritional, aromatherapy and reflexology therapists. It will open to more therapies in due course. Registration means that the practitioner has met certain entry standards, including accredited qualification, and subscribes to a set of professional standards. The Department meets the CNHC regularly to discuss progress.
	CAM, of course, covers a wide range of disciplines, and I believe that it is right to keep our options open and to continue to support research into new therapies and treatments. It is also right that we choose and fund those treatments that are effective, cost-effective and safe. That decision must be based on robust clinical standards, backed up by rigorous and evidence-based scientific assessment. I thank the hon. Gentleman for raising such an important issue this evening.

David Tredinnick: rose—

Gillian Merron: I think that that intervention demonstrates why it is so important for the Government to take the position of not being for or against specific complementary and alternative medicine, and—as I said at the beginning of my speech—treating it in the same way as mainstream medicine. I am aware of the other matter that the hon. Gentleman mentioned, but obviously neither I nor the Government can control what people put in blogs or letters. What we can do, I think, is rise above it, and I believe that that is what we have done by providing the information that we have provided.
	I thank the hon. Gentleman for initiating the debate. He has made a great contribution and a strong case for the views that he holds, and I know that the House will be grateful for that.
	 Question put and agreed to.
	 House adjourned.